三氧化二砷联合VTD方案治疗多发性骨髓瘤的疗效观察

目的本研究观察三氧化二砷联合VTD方案化疗治疗初治多发性骨髓瘤（MM）的临床疗效。方法11例初治的多发性骨髓瘤（MM）患者，中位年龄62．6岁，最大年龄83岁，接受预先短程三氧化二砷（As203）再联合硼替佐米、沙利度胺、地塞米松（VTD方案）治疗，每例患者至少接受2—6个疗程的治疗。观察其总体有效率及毒副作用的发生情况。结果11例初治的患者中3例完全缓解（CR），6例非常好的部分缓解（VGPR），2例部分缓解（PR）。治疗后，总有效率达100％。最长随访治疗17个月，均保持持续缓解状态。主要不良反应包括周围神经症状、水肿、乏力和血小板减少，经对症治疗后均能改善，未发现严重毒副作用。结论三氧化二砷联合VTD方案化疗治疗初治的、尤其老年MM安全、有效，有良好治疗前景。

Effect of arsenic trioxide combining with VTD regimen chemotherapy in treatment of multiple myeloma

Objective To observe the efficacy of arsenic trioxide （As203） combined with VTD regimen chemotherapy in the treatment of primary patients with multiple myeloma （ MM ）o Methods 11 de novo multiple myeloma patients, with a median age of 62.6, the maximum age 83 years old, received the treatment using pretreatmemnt of low dose As203 in com- bination with bortezomib-thalidomide-dexamethason regimen （VTD）. Each patient received treatment of 2- 6 courses . Response and safety was assessed. Results The results showed that out of 11 newly diagnosed Patients, 3 cases acheieved CR, 6 cases acheived VGPR, 2 cases acheived PR, resulting in an ORR of 100%. The main toxicities were peripheral neuropathy （PN）, edema, fatigue, thrombocytopenia. All adverse events were improved by using routine ways. Severe side effects were not observed in treatment. Conclusions Our results support the use of As203 combined with VTD regimen as a highly effective induction regimen in treatment of multiple myeloma, especially for elderly patients.