小剂量沙利度胺联合含小剂量地塞米松的VAD方案治疗老年多发性骨髓瘤的研究  

Clinical study of low dose thalidomide in combination with low dose dexamethasone VAD regimen for senile multiple myeloma

作　　者：王艳军[1] 张学勇[1] 叶继锋[1] 程立新[1] 潘琳莉[1] 

机构地区：[1]聊城市第二人民医院血液科,山东聊城252600

出　　处：《临床血液学杂志》2011年第5期532-534,共3页Journal of Clinical Hematology

基　　金：聊城市科技发展项目(No:2010ZC014)

摘　　要：目的:观察小剂量沙利度胺联合含小剂量地塞米松的VAD方案治疗老年多发性骨髓瘤的疗效。方法:回顾性分析46例多发性骨髓瘤患者,分为治疗组及对照组。对照组采用标准剂量的VAD方案,治疗组应用小剂量沙利度胺及小剂量地塞米松(40mg.d-1,只应用4d)的VAD方案联合治疗,4周为1个疗程,3个疗程后观察疗效。结果:治疗组有效率为83.34%,略高于对照组(72.72%),但差异无统计学意义(P>0.05)。治疗后,治疗组血红蛋白高于对照组(P<0.05),肌酐低于对照组(P<0.05),卡氏评分高于对照组(P<0.05),骨痛评分明显低于对照组(P<0.05)。沙利度胺的主要不良反应为嗜睡、便秘及下肢深静脉血栓形成,但减低了剂量后未见严重上述不良反应。大剂量地塞米松的不良反应为血糖升高及增加感染的发生率,但本研究中减少了地塞米松的剂量,高血糖及感染的发生率明显降低,与对照组比较差异有统计学意义(P<0.05)。结论:小剂量沙利度胺联合含小剂量地塞米松的VAD方案与标准剂量的VAD方案治疗多发性骨髓瘤患者疗效相似,但在改善患者生活质量方面有较好的疗效。并且能减少严重并发症的发生,增加患者治疗的依从性。Objective：To observe the curative effects of low dose thalidomide combined with low dose dexamethasone VAD regimen on elderly patients with multiple myeloma（MM）.Method：The treatments of 46 elderly patients with MM were analyzed retrospectively.All patients were divided into two groups.The patients in control group were treated by VAD regimen with standard dexamethasone,.while the patients in treatment group were treated with the VAD regimen（Vincristione 0.4 mg·d^-1,Adramycin 10 mg·d^-1,Dexamethasone 40 mg·d^-1） for 4 days every month.At the same time,thalidomide is given 150～200 mg·d^-1.Result：There was no significant difference in effect between the two groups（P〈0.05）.After therapy,the changes of Karnofsky scores and hemoglobin content in the treatment group were better than the control group（P〈0.05）.The scores of ostalgia and levels of creatinine in the treatment group were lower than the control group（P〈0.05）.There was significant difference in the high blood glucose and infectious rates as adverse reactions between the two groups（P〈0.05）.Conclusion：Low dose thalidomide combined with low dose dexamethasone VAD regimen does not result in increase of therapeutic effects on MM,but improve the quality of life.

关 键 词：多发性骨髓瘤 沙利度胺 VAD 

分 类 号：R733.3[医药卫生—肿瘤]