羟基喜树碱联合MP方案治疗多发性骨髓瘤的临床研究  

Clinical research of hydroxycamptothecin combine with the scheme of MP in the treatment of multiple myeloma

作　　者：陈永平[1] 方伟[1] 张榜硕[1] 牟庆云[1] 钟晖[1] 王胜[1] 汪从文[1] 邓玲[1] 徐辉[1] 李庆平[1] 

机构地区：[1]重庆三峡中心医院,万州404000

出　　处：《重庆医学》2010年第13期1669-1671,共3页Chongqing medicine

摘　　要：目的观察羟基喜树碱（HCPT）联合MP方案治疗多发性骨髓瘤的临床疗效及不良反应并初步探讨其作用机制。方法 MP方案组：马法兰总量50 mg（2 mg po tid d1-3＋2 mg po qid d4-7）,共7 d;强的松60 mg po qd,共7 d;HCPT＋MP方案组（HMP组）：HCPT5 mg,静滴,qd,共7-10 d;联合MP方案7 d（具体同前）同时使用。7-10 d为1个疗程,间隔28 d开始下1个疗程,共6个疗程。结果 HMP组20例患者中,CR 8例,nCR 6例,PR 4例,MR 2例,ORR为100%。对伴有肾功能损害患者安全有效,对骨破坏有一定的恢复作用。MP方案组32例患者中,CR 2例,nCR 2例,PR 10例,MR 6例,NC 12例,ORR为62.5%。肾功能损害患者肾功能无明显恢复,骨破坏患者骨痛有不同程度缓解但影像学未见明显恢复。两组患者主要不良反应均为骨髓抑制、感染和消化道反应,但不良反应的发生率相当（P〉0.05）。两组治疗前、后血β2微球蛋白、骨髓瘤细胞、乳酸脱氢酶及血红蛋白变化及血清IL-6、TNF-α含量比较,差异有统计学意义（P〈0.05）。结论 HCPT联合MP方案治疗初诊多发性骨髓瘤与传统MP方案相比疗效好,不良反应发生率相当。Objective To observe the therapeutic effect and adverse events of hydroxycamptothecin combined with the scheme of MP to multiple myeloma （MM）. Methods A team of traditional therapy of MP：patients take L-Sarcolysinum of 48mg and predni- sone of 60 mg/d for a week by mouth. A team of HMP：The main therapeutic schedules were patients received hydroxycamptothecin 5mg/d for 7-10 days,meanwhile the scheme of MP was applied. Results The team of HMP：8 patients were CR ,6 patients nCR, 4 patients PR,and 2 patient was MR. The overall response rate （ORR=CR＋nCR＋PR＋MR） was 100K. It was safety to treat in the patients with renal impairment, and probable had the effect with bone remodeling. The team of traditional therapy：2 patients were CR,2 patients nCR,10 patients PR,6 patients MR,and 12 patients NR. ORR was 62.5%. The renal injury did not recover af- ter the therapy. Bone pain improved in varying degrees but the bone remodeling was not seen by X-ray. The main drug related toxic- ities of the two groups were myelosuppression,influsion and nausea The incidence rates of adverse effect were similar（P〉0.05）. The changes of β2 microglobulin, multiple myeloma cells,lactate dehydrogenase （LDH） and hemoglobin after the different therapies had a statistics difference between the two teams（P〈0.05）. So did the content of IL-6 and TNF in serum. Conclusion Hydroxy- camptothecin combined with the scheme of MP to treat multiple myeloma is more effective than the traditional therapy,and the inci-dence rates of adverse effect were similar.

关 键 词：羟基喜树碱 联合 MP方案 多发性骨髓瘤 

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