新诊断多发性骨髓瘤患者120例临床分析

目的 总结多发性骨髓瘤(MM)的临床特征及各治疗方案疗效.方法 回顾性分析120例新诊断MM患者的临床首发症状、实验室检查资料、治疗方法以MP(美法仑+泼尼松)、M2(美法仑+泼尼松+环磷酸胺+卡莫司汀+长春新碱)、VAD(长春新碱+阿霉素+地塞米松)、BD(硼替佐米+地塞米松)、Thal+DEX(沙利度胺+地塞米松)等方案化疗为主的临床疗效.结果 120例MM患者,发病高峰在40～60岁,平均发病年龄54岁,发病年龄在国内有年轻化趋势;MM首发症状以骨骼疼痛、贫血、感染最为常见;临床疗效:①MP方案和M2方案疗效比较,差异无统计学意义(χ2=2.439,P＞0.05);MP方案和VAD方案疗效比较,差异有统计学意义(χ2=10.626,P＜0.05);MP方案和Thal+DEX方案疗效比较,差异无统计学意义(χ2=5.870,P＞0.05).②M2方案与VAD方案疗效比较,差异有统计学意义(χ2=8.307,P＜0.05);M2方案和Thal+DEX方案疗效比较,差异无统计学意义(χ2=2.592,P＞0.05).③VAD和Thal+DEX方案疗效比较,差异无统计学意义(χ2=0.916,P＞0.05).④BD方案总有效率最高,但由于观察例数尚少,尚需进一步观察.结论 目前国内MM治疗仍以化疗为主,主要方案MP、M2、VAD、BD等,均有一定的疗效,适合不同的患者群体.适宜化疗方案的选择并联合自体或异基因造血干细胞移植将有助于改善该疾病患者的预后.

An clinical analysis of multiple myeloma in 120 newly diagnosed patients

Objective To analyze the clinical features in multiple myeloma(MM)patients, and the summaries the treatment effect of different therapies. Methods The clinical initial symptoms, laboratory data,clinical efficacy of treatment with MP, M2, VAD, BD,T hal + DEX and other chemotherapy in 120 patients newly diagnosed with multiple myeloma were retrospectively analyzed. Results Among 120 MM cases,the incidence peak was situated in 40 - 60 years age group, the mean age at oneset was 54 years, which indicated that the onset age were getting younger in China. Bone pain, anemia, infection were the most common initial symptoms of MM. In terms of clinical efficacy:①Significant difference between MP and VAD programs(χ2 = 10. 626,P ＜0. 05＝,but no significant difference between MP and M2 programs(χ2 = 2. 439, P ＞ 0. 05), MP and Thal + DEX programs(χ2 = 5. 870, P ＞0. 05. ②Significant difference between M2 and VAD programs(χ2 = 8. 307, P ＜ 0. 05＝; No significant difference between M2 and Thal + DEX programs(χ2 = 2. 592, P ＞ 0. 05). ③ No significant difference between VAD and Thal +DEX programs(χ2 =0. 916,P＞ 0. 05). ④BD program is the most efficient program,but this discovery need further confirmation because of the small number of cases observed. Conclusions At present, chemotherapy is the main treatment for MM, most scheme like MP, M2, VAD, BD, etc. , have certain effect depend on different patient groups but remain improving. The choice of appropriate chemotherapy and autologous or allogeneic hematopoietic stem cell transplantation will help to improve the prognosis of the disease.