T-VAD与T-VD方案治疗多发性骨髓瘤的临床分析  

The clinical analysis of multiple myeloma using T-VAD and T-VD regimen

作　　者：王慧君[1] 刘传方[1] 

机构地区：[1]山东大学齐鲁医院血液科,济南250012

出　　处：《临床血液学杂志》2012年第3期311-313,共3页Journal of Clinical Hematology

摘　　要：目的:比较T-VAD(长春新碱加阿霉素加地塞米松加沙利度胺)及T-VD(硼替佐米加地塞米松加沙利度胺)方案的疗效及不良反应。方法:回顾74例初治多发性骨髓瘤患者,40例给予T-VAD方案治疗,34例给予T-VD方案治疗,采用t检验的方法进行疗效比较。结果:T-VAD患者中共18例(46%)缓解,T-VD患者中共27例(79%)缓解,两化疗方案差异有统计学意义(P<0.01)。应用T-VAD方案患者中1例(3%)发生深静脉血栓,7例(17%)发生周围神经病变,16例(40%)出现恶心、呕吐、便秘、腹泻等胃肠道反应,9例(22%)发生程度不等的肺部感染,8例(20%)出现血小板减少;应用T-VD方案的患者中2例(6%)发生深静脉血栓,19例(56%)发生周围神经病变,15例(44%)出现消化道反应,18例(53%)发生肺部感染,8例(24%)出现血小板减少。对两种化疗方案的不良反应进行了比较,其中周围神经病变与肺部感染在两组中差异有统计学意义,而深静脉血栓、消化道反应及血小板减少两组差异无统计学意义。结论:T-VD方案缓解率较高,不良反应多,但多数不良反应都较轻微或者可以预防。Objective：To compare the effect and side-effect in patients with multiple myeloma who were treated with T-VAD regimen and T-VD regimen. Method：To review and analyze 74 newly diagnosed multiple myeloma patients,of whom 40 were given T-VAD and 34 were given T-VD regimen. Result：Out of 40 patients treated with T-VAD regimen,18 patients reached remission and 3 got CR and 15 achieved PR.And out of 34 patients treated with T-VD regimen 27 reached remission and 9 patients achieved CR and 18 reached PR.By T-test analysis,there are significant differences between two groups.The side-effects with T-VAD regimen consisted of deep vein thrombosis（1）,peripheral neuropathy（7）,gastrointestinal symptoms（16）,infection（9）,thrombocytopenia（8）.And the side-effectsn of T-VD regimen contained deep vein thrombosis（2）,peripheral neuropathy（19）,gastrointestinal symptoms（15）,infection（18）,myelosuppression（3）,thrombocytopenia（8）.Adverse effects of two regimen were compared by t-test,there were significant differences in peripheral neuropathy and lung infection. Conclusion：The T-VD regimen could reach better curative effect even though having more adverse reaction,but most of them could be prevented.

关 键 词：多发性骨髓瘤 硼替佐米 沙利度胺 

分 类 号：R551.3[医药卫生—血液循环系统疾病]