沙利度胺联合MP方案治疗多发性骨髓瘤的疗效评价

 目的　比较沙利度胺联合美法仑+泼尼松方案（MPT）与美法仑+泼尼松方案（MP）治疗多发性骨髓瘤（MM）的疗效与患者不良反应。方法　采用回顾性分析，MPT组26例，美法仑每天9 mg／m2口服，第1天至第4天，泼尼松60 mg／m2，第1天至第4天，或者美法仑每天4 mg／m2口服，第1天至第7天；泼尼松每天40 mg／m2口服，第1天至第7天，28 d为1个疗程，沙利度胺自化疗开始持续给药，100～200 mg／d，每4周为1个疗程，MP组21例，美法仑及泼尼松用法用量同MPT组，6个疗程后评价总疗效。结果　MPT组的总有效率（ORR）为65.4 %，明显高于MP组的42.9 %（P＞0.05）；MPT组中位反应时间为2个月，MP组为3个月;MPT组患者治疗后血红蛋白及清蛋白升高明显高于MP组（P＜0.05）；MPT组不良反应的发生率高于MP组（P＜0.05），但两组3度以上的不良反应差异无统计学意义；MPT组中位无进展生存时间（PFS）为11个月，2年PFS为66.18 %。结论　与MP方案相比，MPT方案可以提高MM患者的有效率，改善生活质量，延长生存时间，耐受性良好。

Efficacy of thalidomide plus MP regimen for treatment of the patients with multiple myeloma

Objective To compare the efficacy and toxicity of melphalan ＋ prednisone ＋ thalidomide regimen （MPT） and melphalan ＋ prednisonc regimen （MP） in the treatment of multiple myeloma （MM）. Methods 26 patients in MFF group, melphalan 9 mg＇m-2＂d-1 dl-4, prednisone 60 mg/m2 dl-4, or melphalan 4 mg.m^-2.d^-1 d1^-4, prednisone 40 mg/m^2 d1-7 were administrated, every 4 weeks for 1 cycle, and thalidomide was given 100-200 mg/d everyday. 21 cases in MP group, the dose of melphalan and prednisone were the same as that in ／1PT group. The efficacy was evaluated after 6 cycles of treatment. Results The overall response rate （ORR） of MPT group and MP group were 65.4 % and 42.9 %, respectively （P 〉0.05）. The median response time in MPT group versus MP group was 2 months versus 3 months. Compared with the MP group, the increase of hemoglobin and albumin concentration in the MPT group is significantly higher （P 〈 0.05）. The incidence of adverse effects of MPT group was higher than that of MP group （P 〈0.05）, but the percentage of grade 3 and grade 4 toxicity was no different. The median PFS in MPT group was 11 months, 2-year PFS was 66.18 %. Conclusion Compared with MP, MPT could achieve higher response rate, improve the life quality and prolong the survival time of MM patients with better tolerance.