沙利度胺联合VAD方案治疗多发性骨髓瘤的疗效观察以及对IL-6和VEGF的影响

【目的】本研究观察小剂量沙利度胺联合VAD(长春新碱、阿霉素、地塞米松,T-VAD)方案治疗多发性骨髓瘤(MutipleMyeloma,MM)的疗效以及不良反应;通过观察T-VAD方案治疗MM对血清IL-6和VEGF水平的影响,探讨IL-6和VEGF与MM发病机制的关系。【方法】使用T-VAD方案治疗初发和/或复发的MM患者39例3个疗程以上,治疗前及治疗期间定期检测血、尿常规,血沉,肝、肾功,血钙、磷,血糖,免疫球蛋白定量,轻链、蛋白电泳,血乳酸脱氢酶以及骨髓穿刺等检查;ELISA方法检测T-VAD方案治疗前及治疗2、3疗程后血清IL-6和VEGF水平,并与正常对照组比较。【结果】39例MM患者经T-VAD方案治疗完全缓解率为35.9%,部分缓解率为51.3%,总有效率为92.3%,不良反应轻。MM患者血清IL-6和VEGF水平均显著高于正常对照组(P<0.01),T-VAD方案治疗MM患者3个疗程后血清IL-6和VEGF水平均较治疗前显著下降(P<0.01)。【结论】T-VAD方案治疗MM疗效好,不良反应轻。初发、复发MM患者血清IL-6和VEGF水平均显著升高,经T-VAD方案治疗MM患者血清IL-6和VEGF水平显著下降。

Observe the efficacy of thalidomide combined with VAD Programtreat on Multiple Myeloma patient and in the impact of IL-6 and VEGF

[Objective] To observe the efficacy of the thalidomide combined VAD [Vincristine （VCR）, Adriamycin （ADM）, Dexamethasone （DEX）, T-VAD）] in the treatment of multiple myeloma （Multiple Myeloma, MM）, and the adverse reaction as well as; by observing the T-VAD in the treatment of MM on serum levels of interleukin-6（IL-6） and vascular endothelial cell growth factor（VEGF） explore the relationship of IL-6 and VEGF with the mechanism of pathogenesis of MM. [Methods] Collect 39 newly diagnosed and relapsed MM patients,observe the efficacy and adverse reactions of T-VAD,to do regular tests of blood routine,urine routine, ESR, liver, renal function, calcium,phosphorus,glucose,quantitative immunoglobulin,light chain, protein electrophoresis, blood lactate dehydrogenase, as well as bone marrow puncture and other tests, observe the efficacy of T-VAD program, record the adverse reactions; Detect serum IL-6 and VEGF levels pre-treatment and 2,3-course after treatment using ELISA method and compared with normal control group. [ Results] T-VAD in the treatment of MM patients with complete remission rate was 35.9%, partial remission rate was 51.3%, with a total effective rate was 92.3%. were no significant bone marrow suppression. MM patients with serum IL-6 and VEGF （p 〈0.01 ） were significantly higher than the normal control group, T-VAD in the treatment of MM treatment serum IL-6 and VEGF（p 〈 0.01） levels in serum were significantly decreased after treatment with T-VAD program. [Conclusion] The treatment of T-VAD program has good curative effect for MM patient,good compliance with low-dose thalidomide,and the adverse reaction is trifling. IL-6 and VEGF levels in serum of MM patients increase signifieantly;IL-6 and VEGF levels in serum decrease significantly after treatment with T-VAD program.