小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤的临床研究(1)
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[摘要] 目的：评价小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤的临床疗效及不良反应。方法：将40例多发性骨髓瘤患者分成两组，T-VADM 组22例，给予沙利度胺，起始剂量为50 mg QN，无不良反应则每周递增50 mg，最大剂量为200 mg QN；长春新碱 0.4 mg/d，持续静滴24 h，第1~4天；THP 10 mg/d，持续静滴24 h，第1~4天；地塞米松40 mg/d，静滴，第1~4天；马法兰8 mg/(m2·d)，第1~4天，口服，28 d为1个疗程。VAD组18例，给予经典VAD方案。结果：治疗组4例CR，12例PR，3例MR，总有效率为86.4%，对照组无一例达CR，9例PR，MR 2例，总有效率为61.1%，两组疗效比较差异有统计学意义(P<0.05)；不良反应，治疗组出现糖尿病、感染、消化性溃疡等严重不良反应较对照组明显减少，且没有出现严重的骨髓抑制。结论：小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤疗效确切，副作用少，值得临床深入研究及推广应用。
[关键词] 沙利度胺；VADM方案；多发性骨髓瘤；不良反应
[中图分类号] R733.3[文献标识码] C[文章编号] 1674-4721(2011)06(b)-024-03
Clinical study of the effect and side-effects in patients with multiple myeloma by the treatment of T–VADM
WU Yanping1, MO Jun2
1.Department of Hematology, Taishan People's Hospital, Guangdong Province, Taishan 529200, China; 2.Department of Laboratory, Taishan People's Hospital, Guangdong Province, Taishan 529200, China
[Abstract] Objective: To evaluate the efficacy and side effects of thalidomide combined with VADM in the treatment of initial multiple myeloma (MM). Methods: Forty cases with initial MM were randomly divided into two groups. The T-VADM group were 22 patients, treated with low dose thalidomide accompanied with VADM. Thalidomide 50 mg was given orally everynight with serial increments of 50-100 mg at weekly interval until 200 mg/d. VCR 0.4 mg/d d1-4, THP10 mg/d d1-4, Dexamethasone 40 mg/d, d1-4. Each cycle lasted for 28 days. The VAD group were 18 patients, treated with classical VAD. Results: In the study group, there were 4 cases in complete remission, 12 cases in partial remission and 3 cases in improvement. The overall response rate was 86.4%. In the control group, there was a partial response in 13 cases and improvement in 2 cases. The overall response rate was 61.1%. The overall response rate in two groups had significant difference (P<0.05). And the side effects, such as diabetes mellitus, infection and peptic ulcer reduced obviously in the study group (P<0.05). Conclusion: The merits of the T-VADM regimen (thalidomide companied with VADM) in the initial of multiple myeloma are significant response rate, less side effects and good tolerance ......
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