多疗程T-VAD方案治疗68例初发多发性骨髓瘤

郑引索，姚亚洲，陈涛

（宝鸡市中心医院血液风湿病科，陕西 宝鸡，721008）

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摘要：

目的 观察多疗程T-VAD方案治疗初发多发性骨髓瘤(MM)临床疗效。方法 选取我科2009年12月至2015年7月采用多疗程T-VAD方案治疗68例初发多发性骨髓瘤患者病例资料进行总结分析。结果 4个疗程T-VAD方案治疗后完全缓 解（CR）4例、很好部分缓解（VGPR）12例、部分缓解（PR）20例、疾病稳定（SD）22例、疾病进展（PD）10例，总有效率（CR+ VGPR+PR）为52.94%。4个疗程治疗后Hb（g/L）较治疗前升高（t=2.683，P<0.01），β2-MG（mg/L）下降（t=2.784，P<0.01），Cr（mg/L）下降（t=1.963，P<0.05），Cr（umol/L）下降（t=1.971，P<0.05），骨髓瘤细胞数下降（t=1.968 P<0.05），化疗期间患者均有不同程度的恶心、呕吐、脱发及骨髓抑制，部分患者出现嗜睡、肢体末端麻木、便秘、肺部感染等不良反应，给予抗感染、营养神经、对症治疗后好转或减轻。结论 T-VAD联合治疗多发性骨髓瘤疗效明显，适合经济困难患者应用。

关键词：多发性骨髓瘤；沙利度胺；VAD 方案

中图分类号：R733.3文献标志码：A文章编号：2096-1413(2017)05-0003-03

The efficacy observation of treatment of T-VAD Regimen in 68 cases of primary multiple myeloma
ZHENG Yin-suo, YAO Ya-zhou, CHEN Tao
(Department of Rheumatology, Blood Center Hospital of Baoji, Baoji 721008, China)

ABSTRACT: Objective To observe the clinical efficacy of T-VAD regimen for primary multiple myeloma (MM). Methods Sixty-eight patients with MM from December 2009 to July 2015 received thalidomide and VAD regimen were enrolled in our research. Results After treated with T-VAD regimen for 4 courses. 4 patients achieved complete relieve, 12 patients achieved very good partial responses, 20 patients achieved partial remission, 22 patients achieved disease stability and 10 patients were rated as disease progression, the total effective was 52.94%. After four courses of treatment, the Hb level (g/L) was higher than before treatment (t=2.683, P<0.01), β2-MG (mg/L) was decreased (t=2.784, P<0.01), CRP was decreased (mg/L) (t =1.963, P<0.05), Cr was decreased (umol/L) (t =1.971, P<0.05), the number of myeloma cells was decreased (t=1.968, P<0.05); during the period of chemotherapy patients appeared varying degrees of nausea, vomiting, hair loss and bone marrow suppression, some patients appeared sleepiness, numbness of the extremities, constipation, adverse reactions such as pulmonary infection, but the patients were given fight infection, nerve nutrition, the symptom were reduced or alleviated. Conclusions The curative effect of T-VAD joint treatment of multiple myeloma is obvious, which is suitable for patients with economic difficulties.
KEYWORDS: multiple myeloma; thalidomide; VAD regimen

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