联合砷剂治疗难治复发性多发性骨髓瘤疗效观察

目的探讨联合砷剂治疗难治复发多发性骨髓瘤的疗效及其应用价值。方法30例难治复发性多发性骨髓瘤患者分为2组,分别采用亚砷酸联合VAD方案化疗和亚砷酸联合VitC。其中,亚砷酸10mg/d静脉滴注,连续10天,VitC（2g/d）,连用10d,每月1次,4～6个周期判断治疗效果及毒副作用。结果联合亚砷酸化治疗难治复发性多发性骨髓瘤的总有效率为76.7%,其中显效30.0%、进步46.7%;亚砷酸＋VAD方案有效率80.0%;亚砷酸＋VitC方案有效率73.4%。长期随访16例,8例保持持续缓解状态达1年以上。主要不良反应为白细胞减少、继发感染、消化道反应、肝功能损害。结论联合砷剂治疗难治复发性多发性骨髓瘤总有效率较高,且亚砷酸联合维生素C治疗毒副反应低,耐受性好,很有临床应用前景。

The clinical study of the efficacy and application value of combining arsenicals to treat refractory or relapsed multiple myeloma

Objective To investigate the efficacy and application value of combining arsenicals to treat refractory or relapsed multiple myeloma.Methods 30 cases with refractory or relapsed multiple myeloma were divided into two groups,adopting arsenious acid incorporation with VAD chemotherapy regimen and arsenious acid incorporation with VitC separately.And in it,intravenous drip with arsenious acid 10mg/d for 10 days,VitC(2 g/d) for 10 days,once each month,to judge the therapeutic effects and its side effects after 4 to 6 periods.Results The total effective rate of combining arsenious acid to treat refractory or relapsed multiple myeloma was 76.7%,markedly effective 30.0%,improve 46.7%.The effective rate of adopting arsenious acid incorporation with VAD chemotherapy regimen was 80.0%.The effective rate of arsenious acid incorporation with VitC was 73.4%.Long-term follow-up 16 cases,8 cases persistent remission for over one year,the main side effects were leukocytopenia,secondary infection,digestive tract reaction and liver function damage.Conclusions Arsenical was efficient to refractory or relapsed multiple myeloma.And arsenious acid combining vitamin C treatment has the advantage of low adverse reaction and well tolerance.Therefore,it has a prospect of clinical applications.