VAD方案治疗初发的多发性骨髓瘤临床疗效观察  

The clinical efficacy observation of VAD regimen in the treatment of newly diagn osed multiple myeloma

作　　者：徐岚[1] 韩洁英[1] 钟璐[1] 钟华[1] 黄洪晖[1] 陈芳源[1] 欧阳仁荣[1] 

机构地区：[1]上海第二医科大学附属仁济医院血液科,上海200001

出　　处：《中国癌症杂志》2005年第1期70-71,74,共3页China Oncology

摘　　要：　　　目的:评估VAD方案应用于初发Ⅲ期的多发性骨髓瘤(MM)治疗效果。方法:入组的 26例初次诊断为MM的患者,临床分期均属于Ⅲ期。VAD联合化疗方案包括:长春新碱(VCR);阿霉素(ADM);地塞米松(Dex),连续应用 3疗程以上评估疗效。检查项目包括:血清M蛋白、肾功能、24小时尿蛋白定量、骨髓穿刺,外周血象等检测,并记录不良反应。MM疗效标准,分为完全缓解 (CR)、部分反应 (PR)、微小反应 (MR)、无改变 (NC)、平台期。结果: 5例获得完全缓解(19. 3% ),部分缓解 13例(50% ),微小反应 6例(23% ), 2例无改变 (7. 7 % )。总有效率(92. 3% )。平均生存期(29. 6±17)月(7月 84月)。结论:VAD方案治疗Ⅲ期初发MM的临床疗效显著。肾功能不全,临床症状明显的患者VAD治疗起效快,症状改善明显。Purpose: To evaluate the clinical efficacy of V AD regimen in the treatment of newly diagnosed stage III multiple myeloma (MM). Methods:26 patients with newly diagnosed stage Ⅲ multiple myel oma were treated with VAD regimen. VAD solution consisted of vincristine (VCR) , doxorubicin(ADR),dexamethasone (Dex).Three continuous treatments in one treatm ent course were considered evaluable.Evaluation included results of serum myelom a protein(M-protein); renal function; proteinuria of 24-hours; bone marrow ; per ipheral blood et al.The side reactions were recorded. The clinical efficacy eval uation was divide into complete response(CR),partial response(PR),minimal-respon se(MR), no change(NC) , plateau progression.Results:5 cases achieved CR(19.3%), 13 cases PR(50%),6 case s MR (23%), 2 cases no change (7.7%). Overall response rate was 92.3%, median su rvival duration was 7 to 84 months (29.6±17months). Conclusions:Achieved marked clinical efficacy with VAD agent in newly diagnosed stage III multiple myeloma. Especially,the patients with renal failure and serious clinical manifestation improved rapidly and significantly.

关 键 词：多发性骨髓瘤 化学疗法 长春新碱 多柔比星 

分 类 号：R730.53[医药卫生—肿瘤] R733.3[医药卫生—临床医学]