羟基喜树碱联合MP方案治疗多发性骨髓瘤的临床研究

目的 观察羟基喜树碱(HCPT)联合MP方案治疗多发性骨髓瘤的临床疗效及不良反应并初步探讨其作用机制.方法 MP方案组:马法兰总量50 mg(2 mg po tid d1～3+2 mg po qid d4～7),共7 d;强的松60 mg po qd,共7 d;HCPT+MP方案组(HMP组):HCPT 5 mg,静滴,qd,共7～10 d;联合MP方案7 d(具体同前)同时使用.7～10 d为1个疗程,间隔28 d开始下1个疗程,共6个疗程.结果 HMP组20 例患者中,CR 8例,nCR 6例,PR 4例,MR 2例,ORR为100%.对伴有肾功能损害患者安全有效,对骨破坏有一定的恢复作用.MP方案组32例患者中,CR 2例,nCR 2例,PR 10例,MR 6例,NC 12例,ORR为62.5%.肾功能损害患者肾功能无明显恢复,骨破坏患者骨痛有不同程度缓解但影像学未见明显恢复.两组患者主要不良反应均为骨髓抑制、感染和消化道反应,但不良反应的发生率相当(P>0.05).两组治疗前、后血β2微球蛋白、骨髓瘤细胞、乳酸脱氢酶及血红蛋白变化及血清IL-6、TNF-α含量比较,差异有统计学意义(P<0.05).结论 HCPT联合MP方案治疗初诊多发性骨髓瘤与传统MP方案相比疗效好,不良反应发生率相当.

Clinical research of hydroxycamptothecin combine with the scheme of MP in the treatment of multiple myeloma

Objective To observe the therapeutic effect and adverse events of hydroxycamptothecin combined with the scheme of MP to multiple myeloma(MM).Methods A team of traditional therapy of MP:patients take L-Sarcolysinum of 48mg and prednisone of 60 mg/d for a week by mouth.A team of HMP:The main therapeutic schedules were patients received hydroxycamptothecin 5mg/d for 7-10 days,meanwhile the scheme of MP was applied.Results The team of HMP:8 patients were CR,6 patients nCR,4 patients PR,and 2 patient was MR.The ...