CE-T方案治疗老年难治复发性多发性骨髓瘤的临床研究

目的探讨环磷酰胺联合足叶乙苷化疗（CE）并序贯口服沙利度胺（Thal）治疗老年难治复发性多发性骨髓瘤的临床疗效及相关毒副作用。方法给予13例老年难治复发性MM患者cE方案化疗：环磷酰胺（CTX）300mg／m^2，dl-3；足叶乙苷（VP-16）75mg／m^2，dl-3。每四周重复，化疗间歇期序贯口服沙利度胺50-75mg，2次／d。4-6疗程后根据患者M蛋白、骨髓浆细胞数、血常规、免疫球蛋白、生化等评价疗效及毒副反应。结果CR1例（7.69％），PR7例（53.85％），SD3例（23.08％），PD2例（15.38％），总缓解率61.54％，且毒副作用较轻。结论CE方案化疗序贯口服沙利度胺疗效确切，毒副反应轻，是治疗难治复发性MM的较为合适的方案，值得临床推广。

The Clinical Research on the CE-T Regimen in the Treatment of the Refractory and Recurrent Multiple Myeloma of the Aged People

Objective To research the clinical curative effect and side effects on the combination of eyclophosphomide （CTX） and etoposide（Vp-16）, and taking thalidomide（Thai） orally in sequential to treat refractory and recurrent multiple myeloma（MM） of the aged people. Methods 13 cases of refractory and recurrent multiple myeloma in old aged were treated with the CE measures ： CTX 300mg/m^2, D1-3 ; Vp-1675 mg/m^2, D1-3, every four weeks. The patients took Thal orally in the intermittence of chemo-therapy , twice one day. After 4 - 6 periods of treatment, we evaluate the clinical curative effect and side effects based on the M protein, the ammount of plasma cells in bone marrow, blood routine, immunoglobin and blood biochemistrical test etc. Results One patient achieved complete remission（CR） , the CR rate was 7.09%. Seven patients achieved partial remission（PR） , the PR rate was 53.85%. Three patients was stable, the SD was 23.08%. The disease of two patients was progressive, The PD rate was 15.38%. The overall remission rate was 61.54%. And meanwhile, the side effects was tolerable. Conclusion The CE-T regimen is a appropriate measure to treat the refractory and recurrent MM in aged people.