DVD方案与VAD方案治疗伴肾功能不全的初治多发性骨髓瘤疗效比较  

Effects of DVD and VAD in the treatment of newly diagnosed mutiple myeloma with renal failure

作　　者：杨建和[1] 卢绪章[2] 韩文敏[1] 陈涛[1] 肖溶[1] 周民[1] 

机构地区：[1]南京医科大学附属常州第二人民医院血液科,213003 [2]南京医科大学附属常州第二人民医院中心实验室,213003

出　　处：《白血病．淋巴瘤》2011年第11期656-658,共3页Journal of Leukemia & Lymphoma

摘　　要：目的探讨DVD方案与VAD方案治疗初治伴肾功能不全的多发性骨髓瘤（MM）的疗效和不良反应。方法15例初治的肾功能不全MM患者采用DVD方案（盐酸多柔比星脂质体40mg静脉滴注，第1天；长春新碱2．0mg静脉注射，第1天；地塞米松40mg／d静脉滴注，第1天至第4天；28d为1个疗程）；19例初治肾功能不全的MM患者采用VAD方案（多柔比星10mg／d静脉滴注，第1天至第4天；长春新碱0．5mg／d静脉滴注，第1天至第4天；地塞米松40mg／d静脉滴注，第1天至第4天、第9天至第12天、第17天至第20天；28d为1个疗程），通过检测患者肾功能恢复情况及临床随访生存时间，评价两种方案的疗效。结果患者对DVD方案和VAD方案的总体有效（OR）率相似[分别为80．0％（12／15）、78．9％（15／19），X2=0．01，P〉0．05]；但是和VAD组比较，DVD组能够迅速降低肌酐水平，且远期疗效DVD组更有优势。结论DVD方案和传统的VAD方案的对初治伴肾功能不全MM的患者疗效及不良反应类似，但DVD方案能够更迅速的缓解病情。Objective To compare the therapeutic effect and toxicity of DVD and VAD regimen for newly diagnosed multiple myeloma with renal failure. Methods Fifteen newly diagnosed multiple myeloma patients with renal failure were treated with DVD regimen （VCR 2 mg and PLD 40 mg/m2 were administered as single dose on day 1, and dexamethasone 40 mg daily on day 1 to 4, 28 days/cycle）; 19 newly diagnosed multiple myeloma patients with renal failure were treated with VAD regimen （VCR 0.5 mg and doxorubicin 10 mg/m2 were administered on day 1-4, and dexamethasone 40 mg daily on day 1-4, 9-12, 17-20, 28 days/ cycle）. The therapeutic effect were investigated between both groups through the recovery of renal function and overall survive. Results Overall response rates （DVD, 80.0 %; VAD, 78.9 %, X^2 =0.01, P 〉0.05） were similar between both groups, but compared with VAD group, DVD group recovered renal function quickly and have a tendency of better overall survive. Conclusion The DVD regimen had similar efficacy compared with traditional VAD. regimen and no significant difference in adverse reaction, but the DVD regimen achieves good response to the patients with renal failure.

关 键 词：多发性骨髓瘤 肾功能不全 抗肿瘤联合化疗方案 

分 类 号：R733.3[医药卫生—肿瘤]