氯屈膦酸二钠联合化疗治疗多发性骨髓瘤的溶骨眭病变的疗效观察

目的探讨氯屈膦酸二钠（clodronate disodium，商品名固令）联合化疗治疗多发性骨髓瘤（multiple mveloma，MM）的溶骨性病变的疗效。方法治疗组20例予氯屈膦酸二钠2400mg／日口服，同时予MP或M2方案化疗；对照组予MP或M2方案化疗。骨痛的缓解和血钙的下降作为评价指标。结果治疗组和对照组用药前均有骨痛，治疗后，治疗组完全缓解7例，部分缓解9例，有效率80％；对照组完全缓解2例．部分缓解6例，有效率44．4％，治疗组有效率高于对照组（P=0．023）。治疗组血钙升高7例，治疗后均降至正常范围，下降率为100％；对照组血钙升高5例，治疗后仅2例降至正常范围，下降率为40％。毒副作用方面，两组病人在用药过程中均未见有严重不良反应，病人耐受性良好。结论氯屈膦酸二钠是一种治疗多发性骨髓瘤伴骨痛和高钙血症的有效药物。

PRELIMINARY STUDY ON THE TREATMENT OF MULTIPLE MYELOMA BY CLODRONATE COMBINED WITH CHEMOTHERAPY

Objective To study the therapeutic effectiveness of clodronate disodium combined with chemotherapy for osteolytic lesion induced by multiple myeloma.Methods In this randomized,controlled study,38 patients with osteolytic lesion induced by multiple myeloma were enrolled.Patients were randomly divided into two groups.20 cases in the treated group(A) and 18 in the control group(B).Patients in group A were treated with clodronate 2 400mg/day orally,combined with chemotherapy(MP or M2).Patients in group B were treated with chemotherapy(MP or M2) only.Two evaluating indices including pain relief and the level of serum calcium were observed.Results The persentage of pain relief in the two groups were 80% and 44.4% respectively.All patients with hypercalcaemia(7/7) were corrected in the group A after treatment of 14 days duration compared to those were 40%(2/5) in group B.Pain relief and the control of hypercalcaemia in group A were superior to those in group B.Patients were well tolerated to clodronate disodium.Conclusions This trial demonstrates that clodronate is an effective drug in the treatment of multiple myeloma associated with bone pain and hypercalcaemia.