T-CEMD方案治疗多发性骨髓瘤的临床研究

目的探讨T-CEMD方案治疗多发性骨髓瘤（MM）的临床疗效和不良反应。方法22例复发难治性MM患者应用T—CEMD方案：沙利度胺100mg，每晚1次；环磷酰胺500mg／m^2，第1天；足叶乙甙70mg／m^2,第1～2天；米托蒽醌4mg／m^2，第1～3天；地塞米松40mg第1～4天；21d为一个疗程。19例初治MM用T—CEMD与VAD类方案交替（T-CEMD／VAD）治疗；18例初治MM单用VAD类方案治疗。结果在22例难治性MM患者中，完全缓解（CR）8例（36％）、部分缓解（PR）12例（55％）、无效（NR）2例（9％），总有效率（0RR）91％。T—CEMD／VAD方案治疗的19例中，CR6例（32％）、PR11例（58％）、NR2例，总有效率（0RR）90％。单用VAD类方案治疗18例初治MM者中，CR1例（6％）、PR8例（44％），ORRS0％。T-CEMD方案的主要不良反应为骨髓抑制。结论T-CEMD方案对复发难治性MM患者中的补救治疗，具有较为理想的疗效。T—CEMD／VAD交替方案治疗初治MM患者，明显优于单用VAD类方案。

The Clinicl Study of T-CEMD Regimen in the Treatment of Multiple Myeloma

Objective To investigate the efficacy and adverse effects of T-CEMD regimen in the treatment of multiple myeloma （MM）. Methods Twenty-two patients with refractory or relapsed MM were treated by T-CEMD regimen;19 patients with MM were treated by T-CEMD/VAD regimen;18 patients with MM were treated by VAD like regimen. Results Out of 22 patients with refractory or relapsed MM were treated by T-CEMD regimen,8 achieved CR,12 achieved CR,ORR were 91%（20/22）;Out of 19 patients with MM were treated by T-CEMD/VAD regimen,6 achieved CR,11 achieved CR,ORR were 90%（17/19）;Out of 18 patients with MM were treated by VAD like regimen,1 achieved CR,8achieved CR,ORR were 50%（9/18）. The main toxicities of T-CEMD regimen Were marrow depressed. Conclusion The T-CEMD regimen is more effective treatment to patients with refractory or relapsed MM; The T-CEMD/VAD regimen is an very effective way as induction treatment in new-diagnosed MM.