低剂量环磷酰胺联合泼尼松治疗多发性骨髓瘤的临床疗效及对血清VEGF、PDGF-BB水平的影响  

Clinical effect of low-dose cyclophosphamide and prednisone in treatment of multiple myeloma and its influence on serum VEGF,PDGF-BB levels

作　　者：郭列平[1] 周帆[1] 韦苇[1] 张忆梓[1] 石昊天[1] 凌晨晖[1] 李璐[1] 侯健[2] 

机构地区：[1]上海市闸北区中心医院血液肿瘤科,上海200070 [2]第二军医大学长征医院血液科,上海200003

出　　处：《第二军医大学学报》2012年第4期413-416,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨低剂量环磷酰胺联合泼尼松(CP方案)治疗多发性骨髓瘤的临床疗效及其对血清血管内皮生长因子(VEGF)和血小板源性生长因子BB(PDGF-BB)水平的影响。方法 54例难治或复发性多发性骨髓瘤患者给予低剂量环磷酰胺(CTX,50 mg/d)联合泼尼松(Pred,15 mg/d)持续口服,评价疗效。于治疗前和治疗后2、4、6个月分别取患者的血清并应用ELISA法检测血清中VEGF和PDGF-BB的表达。结果治疗总有效率达69%(36/52)。其中有效并重复检测血清标本4次的患者30例(其中完全缓解2例,非常好的部分缓解4例,部分缓解24例),可评估无效患者7例。此30例有效组多发性骨髓瘤患者治疗2、4、6个月后血清VEGF和PDGF-BB水平与治疗前相比均降低,差异有统计学意义(P<0.01);而7例无效组多发性骨髓瘤患者治疗2个月后血清VEGF和PDGF-BB水平与治疗前相比差异无统计学意义。结论低剂量环磷酰胺联合泼尼松治疗多发性骨髓瘤患者有明显疗效,并可降低血清VEGF及PDGF-BB水平。推测其在多发性骨髓瘤中的作用机制可能与抑制新生血管的生成有关。Objective To investigate the clinical effect of low-dose cyclophosphamide plus prednisone（CP regimen） in treatment of multiple myeloma（MM） and its influence on serum levels of vascular endothelial growth factor（VEGF） and platelet-derived growth factor BB（PDGF-BB）.Methods Totally 54 patients with refractory or relapse MM were continuously treated with CP regimen： oral cyclophosphamide（CTX,50 mg/d） and prednisone（Pred,15 mg/d）.The peripheral blood samples were collected from each group 0,2,4,and 6 months after treatment.Serum VEGF and PDGF-BB levels were analyzed by ELISA.Results The overall effective rate was up to 69%（36/52） in our study.The treatment was effective in 30 patients,including 2 complete response（CR） cases,4 very good partial response（VGPR） cases and 24 partial response（PR） cases,and their serum samples were examined for 4 times.The serum levels of VEGF and PDGF-BB were significantly decreased in the 30 patients at 2,4,and 6 months after treatment（P〈0.01）;while their levels were not significantly change in the 7 invalid patients 2 months after treatment compared with before treatment.Conclusion Low-dose cyclophosphamide plus prednisone has noticeable effect in treatment of MM patients;it can also greatly down-regulate serum VEGF and PDGF-BB levels.The mechanisms of CP regimen in MM patients may be associated with the inhibition of new blood vessel generation.

关 键 词：环磷酰胺 泼尼松 多发性骨髓瘤 血管内皮生长因子 血小板源性生长因子 

分 类 号：R733.3[医药卫生—肿瘤]