沙利度胺联合改良VAD方案治疗多发性骨髓瘤临床观察

目的观察沙利度胺联合化疗治疗多发性骨髓瘤（MM）的疗效及不良反应。方法15例多发性骨髓瘤患者分成2组,对照组用改良VAD方案化疗,治疗组在改良VAD方案上加用沙利度胺,治疗6个疗程,根据血清M蛋白、骨髓瘤细胞减少等指标判断疗效。结果总有效率治疗组85.7%,对照组50%,两组间差异有显著性（P〈0.05）。治疗组中便秘、腹胀和水肿增加,经对症处理后较快消失,其他不良反应与对照组相同。结论沙利度胺联合改良VAD方案化疗治疗MM具有疗效明显增加,耐受性良好的优点。

Clinical investigation of thalidomide with VAD in the treatment of multiple myeloma

Objective To investigate the preliminary result of therapy with thalidomide in the treatment of multiple myeloma （MM） patients. Methods Fifteen patients with MM were divided into two groups：8 cases were treated by chemotherapy with vincrietione,adriamycin and dexamethasone（VAD） named control group,and 7 cases named treatment group were treated by thalidomide with VAD.The initial dose of thalidomide was 100mg/d,then increased 50mg/d to 400mg/d every week until the patient＇s maximal tolerance.Contrast clinical efficacy according to M-protein and myeloma cell after 6 cycle. Results Effective rate of treatment group 85.7% was higher than control group 50% （P〈0.05）.Constipation,abdomen distension,and dropsy in treatment group was more often than control group,to resume in short time allowing symptomatic treatment. Other side effects among the two groups were similary. Conclusion Thalidomide with VAD can be used in the treatment of MM,it increases the efficacy and its tolerance is tolerable.