沙利度胺联合化疗治疗多发性骨髓瘤的临床观察

目的探讨沙利度胺联合马法兰+泼尼松化疗方案治疗多发性骨髓瘤(MM)的临床疗效及不良反应。方法选取2008年10月至2013年1月在鄂州市中心医院血液科住院治疗的MM患者55例,按随机数字表法分为对照组27例,采用马法兰+泼尼松化疗方案予以治疗;观察组28例,在对照组治疗基础上加用沙利度胺治疗。观察两组临床疗效、M蛋白、骨髓瘤细胞、β2微球蛋白(β2-GM)和血红蛋白等指标变化。结果观察组治疗总有效率地显著高于对照组(78.6%vs 59.3%)(P<0.05);两组治疗后M蛋白、MM细胞和β2-GM等指标显著地下降,而血红蛋白明显上升,观察组改善更为明显(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论沙利度胺联合马法兰+泼尼松化疗方案治疗MM疗效显著,未出现严重不良反应,值得临床推广应用。

The Clinical Observation of Thalidomide Combined with Chemotherapy in the Treatment of Multiple Myeloma

Objective To investigate the clinical curative effect and adverse reactions of thalidomide combined with melphalan and prednisene （ MP ） chemotherapy in the treatment of multiple myeloma（MM）. Methods According to the digital random method,55 patients with MMfrom Hematology Department of Ezhou Central Hospital were divided into the control group（ n = 27 ） treated with MP chemotherapy regimens,and observation group （ n = 28 ） treated with thalidomide on the base of control group. The clinical curative effect mad the changes of M protein,myeloma eens,[β2-microglobulin （β2-GM）, hemoglobin of the two groups were observed. Results The total effective of treatment group was significantly higher than that of control group （78.6% vs 59.3 % ） （ P 〈 0.05 ）. The M protein, MM cells and beta 2-GM of the two groups after treatment declined obviously,bnt hemoglobin increased,and the observation group improved more significantly （ P 〈 0.05 ）. There was no significant difference between the two groups about incidence of adverse reactions （ P 〉 0.05 ）. Conclusion The treatment of thalidomide combined with MP chemotherapy for multiple myeloma has a distinct curative effect, without serious adverse reaction,thus is worthy of clinical popularization and application.