硼替佐米联合地塞米松与沙利度胺治疗多发性骨髓瘤的效果

目的比较硼替佐米＋地塞米松＋沙利度胺（BDT）方案与长春地辛＋表柔比星＋地塞米松＋沙利度胺（VADT）方案治疗多发性骨髓瘤（MM）的临床效果。方法MM病人67例，应用BDT方案治疗30例，VADT方案治疗37例，均治疗4个疗程，比较两组治疗前、治疗后β2-微球蛋白、免疫球蛋白、骨髓瘤细胞的变化，并比较两组疗效。结果BDT组及VADT组化疗后β2-微球蛋白、免疫球蛋白、骨髓瘤细胞均低于化疗前，差异有显著性（t=2．837～7．562，P％0．05）。BDT组完全缓解（CR）占13．0％，接近完全缓解（ncR）占20．0％，部分缓解（PR）占53．0％，微小反应（MR）占6．7％，总有效率93．3％；VADT组CR占3．0％，nCR占10．8％，PR占40．5％，MR占16．2％，总有效率70．3％，两组疗效比较，差异有显著性（Hc=51．67，P〈0．05）。结论BDT方案治疗MM效果优于VADT方案，且起效快，可改善病人的预后。

EFFICACY OF BORTEZOMIB COMBINED BOTH DEXAMETHASONE AND THALIDOMIDE IN THE TREATMENT OF PA-TIENTS WITH MULTIPLE MYELOMA

Objective To compare the efficacy of bortezomib combined both dexamethasone and thalidomide （BDT） with vindesine＋epirubiein＋ dexamethasone＋thalidomide （VADT） in patients with multiple myeloma （MM）. Methods BDT the- rapy was used for 67 MM patients, and VADT for 37, a treatment of four courses was carried out in both groups. Changes of ~2- microglobulin, immunoglobnlin, and myeloma cells, before and after treatment, between the two groups were observed and com- pared. Results The levels of l？2-microglobulin, immunoglobulin, and myeloma ceils in both BDT and VADT after chemothera- py were lower than that before the treatment, the differences were statistically significant （t= 2. 837-7. 562, P〈0.05）. After four courses of therapy, in BDT group： complete remission （CR） 13. 0X, nearly complete remission （nCR） 20.0%, partial re- sponse （PR） 53.0%, and minimal remission （MR） 6.7%, total effective rate being 93.3% ; in VADT group： that were CR ac- counting for 3.0 %, nCR for 10.8%, PR for 40.5%, and MR for 16.2%, with a total effective rate of 70.3%. The differences between BDT and VADT were statistically significant （Hc=51. 67,P〈40.05）. Conelusion BDT is superior to VADT in the treatment of MM in terms of fast action and improvement of patients＇ prognosis.