沙利度胺联合VAD方案治疗多发性骨髓瘤的疗效

目的:探讨沙利度胺联合VAD方案治疗多发性骨髓瘤(multiple myeloma,MM)的疗效及不良反应。方法:选取2011年1月—2012年12月住院治疗的38例MM患者,将其随机分为对照组和观察组。对照组(VAD组)16例,采用长春新碱+阿霉素+地塞米松治疗;观察组(TVAD组)22例,在对照组治疗方法的基础上加用沙利度胺。比较两组的疗效及不良反应。结果:TVAD组总有效率(77.2%)明显高于VAD组(50.0%),差异有统计学意义(P0.05)。TVAD组治疗后较治疗前血清β2-微球蛋白(β2-microglobulin,β2-MG)、C-反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、浆细胞比例的下降及血红蛋白(haemoglobin,Hb)的升高幅度均大于VAD组,差异有统计学意义(均P0.05)。TVAD组不良反应发生率高于VAD组,不良反应经对症处理后均消失,不影响治疗。结论:沙利度胺联合VAD方案治疗MM疗效显著、给药方便、患者耐受性好。

Efficacy of Thalidomide plus VAD Regimen in the Treatment of Multiple Myeloma

Objective：To explore the clinical efficacy and adverse reactions of thalidomide plus VAD regimen in the treatment of multiple myeloma （MM）. Methods ： From January 2011 to December 2012, 38 MM patients were randomly divided into con- trol group （VAD group, 16 cases） and treatment group （VAD group, 22 cases）, according to the random number table. Patients in VAD group were treated with VAD regimen （combination of leurocristine, adriamycin and dexamethasone）, while patients in TVAD group were given thalidomide besides VAD regimen. The efficacy and the adverse reactions were compared between the two groups. Results： The total effective rate of TVAD group was 77.2%, significantly higher than that of VAD group （50.0% ）, P〈0.05. The decreases of β2 microglobulin （β2-MG）, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR） and plasma cell percentage, and the increase of haemoglobin （Hb） after treatment in TVAD group were more sig- nificant than those in VAD group （all P〈0.05）. The rate of adverse reactions in TVAD group was higher than that in VAD group. However, adverse reactions disappeared after symptomatic treatment. Conclusions： The combination of thalidomide and VAD regimen in the treatment of MM is effective,convenient and better tolerated in patients.