低剂量沙利度胺联合常规化疗治疗多发性骨髓瘤的临床疗效分析

目的:探讨低剂量沙利度胺联合常规化疗治疗多发性骨髓瘤（MM）的临床疗效及不良反应。方法:MM患者26例，根据治疗方式分为观察组（13例）和对照组（13例）；对照组给予常规化疗，观察组在常规化疗基础上添加低剂量沙利度胺，对比2组患者治疗效果、不良反应及预后情况。结果:观察组治疗有效率为84.62%，对照组为46.15%，2组差异有统计学意义（P<0.05）。患者经治疗后出现血小板减少、白细胞降低等血液不良反应，部分患者出现轻度嗜睡、皮疹和便秘等症状，经治疗后症状有所缓解，观察组不良反应发生率为38.46%，对照组为46.15%，2组差异无统计学意义（P>0.05）。观察组无进展生存时间（PFS）为（5.6±1.3）个月，总生存时间（OS）为（11.6±2.5）个月，对照组PFS为（3.8±0.9）个月，OS为（8.4±1.2）个月，观察组PFS和OS治疗后均明显长于对照组（P<0.01）。结论:低剂量沙利度胺联合常规化疗治疗MM效果显著，不良反应少，能有效延长患者生存时间，值得临床推广和应用。

Clinical analysis of low dose thalidomide combined with conventional chemotherapy in the treatment of multiple myeloma

Objective:To investigate the clinical efficacy and adverse reactions of low dose thalidomide combined with chemotherapy in the treatment of multiple myeloma( MM) . Methods:Twenty-six patients with MM were divided into the observation group and control group according to the treatment method(13 cases each group). The control group were treated with conventional chemotherapy,and the observation group were treated with conventional chemotherapy combined with low dose thalidomide. The treatment effect, adverse reaction and prognosis between two groups were compared. Results:The effective rates in observation group and control group were 84. 62% and 46. 15%,respectively,the difference of which was statistically significant(P<0. 05). The thrombocytopenia,leucopenia, mild rash,drowsiness,constipation and other symptoms in some cases were identified after treatment,which were partially relieved after treatment. The incidence rates of adverse reactions in observation group and control group were 38. 46% and 46. 15%,respectively,the difference of which was not statistically significant(P >0. 05). The progression-free survival(PFS) and overall survival(OS) in observation group and control group were(5. 6 ± 1. 3) &(11. 6 ± 2. 5) months and (3. 8 ± 0. 9) &(8. 4 ± 1. 2) months,respectively. The PFS and OS in observation group were significantly longer than those in control group(P <0. 01). Conclusions:The low dose thalidomide combined with conventional chemotherapy after treatment multiple myeloma is good effect and less adverse reaction,which can effectively prolong the survival of patients,and is worthy of promotion and application.