沙利度胺联合化疗治疗多发性骨髓瘤的临床观察

目的: 探讨沙利度胺联合化疗治疗多发性骨髓瘤的临床疗效及不良反应。方法: 治疗组21例采用沙利度胺联合化疗,沙利度胺自化疗开始给药,剂量200 mg/d,分早、晚口服,4周后无效增至300 mg/d,维持该剂量半年。化疗方案分别为MP、VAD、VMCP。1个月为1个疗程。对照组24例,单纯化疗,化疗的方案、药物的剂量均同治疗组。结果: 治疗组部分缓解13例,进步4例,无效4例,总有效率80.95%,明显高于对照组(总有效率54.17%)(P<0.01);治疗组主要疗效指标的改善率均优于对照组(P<0.05~P<0.005)。常见的不良反应有便秘、嗜睡、皮疹、两下肢水肿等,但均可耐受。结论: 沙利度胺联合化疗治疗多发性骨髓瘤具有副作用少、耐受性好、给药方便、疗效明显的优点,值得临床深入研究和推广应用。

Thalidomide combined with chemotherapy in treatment of multiple myeloma

Objective:To study the curative effect and side effect of thalidomide combined with chemotherapy in treatment of multiple myeloma.Methods:The treatment group(21 cases) was administered thalidomide at a dose of 200 mg/d and chemotherapy.The dosage increased to 300 mg/d after 4 weeks when the effect was not satisfactory,which was maintained for half a year.The chemotherapy regimens were MP,VAD and VMCP.The control group(24 cases) was given chemotherapy only.The chemotherapy regimens and doses were the same with the treatment group.Results:In the treatment group,3 cases had partial relief(61.90%),4 cases improved(19.05%) and 4 cases had no response(19.05%).The total efficacy rate was 80.95%,which was significantly higher than that of the control group(with a total efficacy rate of 54.17%)(P<0.01).The improvement rate of most indexes in the treatment group was higher than that in the control group(P<0.05-P<0.005).The side effects included constipation,lethargy,dermatitis and edema in the two low limbs,which were all tolerable.Conclusions:Thalidomide combined with chemotherapy in treatment of multiple myeloma has the merits of fewer side effects,good tolerance,convenient administration and significant curative effect.It is worth popularizing.