环磷酰胺联合VAD方案治疗多发性骨髓瘤的免疫效应和疗效评估  

Immune effect and therapeutic analysis of cyclophosphamide combined VAD regimen in treatment of multiple myeloma

作　　者：孙薏[1] 颜斌[1] 钟国成[1] 卢海波[1] 冯怀志[1] 陈健[1] 廖皓[1] 胡露[1] 

机构地区：[1]解放军第452医院血液肿瘤中心,四川成都610021

出　　处：《西部医学》2014年第1期40-42,共3页Medical Journal of West China

基　　金：四川省卫生厅科研资助项目(090173)

摘　　要：目的探讨环磷酰胺联合表柔比星+长春地辛+地塞米松(VAD)方案治疗多发性骨髓瘤(MM)的免疫效应和临床疗效。方法选择48例MM患者作为研究对象,采用经典数字表随机分为联合组24例,采用环磷酰胺联合VAD方案治疗;对照组24例,接受单纯VAD方案治疗,比较两组患者治疗后的免疫抑制性指标、临床疗效和不良反应。结果化疗6周期后,联合组患者的免疫抑制性指标(调节性T细胞百分比、转化生长因子-β、白介素-6、干扰素-γ与白介素-10的比值),临床疗效指标(瘤细胞百分比、β2-微球蛋白、24小时尿液轻链、血清尿素氮)均明显优于对照组(P<0.05);治疗后,联合组患者总有效率79.2%(19/24),其中CR 4例(占16.7%),nCR 6例(占25.0%),PR 9例(占37.5%),SD 3例(占12.5%),PD 2例(占8.3%)。对照组患者总体有效率55.0%(11/20),其中CR 1例(占5.0%),nCR 3例(占15.0%),PR 7例(占35.0%),SD 5例(占25.0%),PD 4例(占20.0%),两组之间差异有统计学意义(P<0.05);而两组患者的不良反应发生率之间差异无统计学意义(P>0.05),经对症处理后均能缓解。结论环磷酰胺联合VAD方案治疗MM是一种安全、可靠、有效的治疗方法。Objective To observe the immune effect and clinical curative effect of cyclophosphamide combined the VAD Regimen （C-VAD） in treatment of multiple myeloma （MM）. Methods 48 patients with MM in our hospital were divided into two groups at random. 24 patients were treated with C-VAD and the other 24 patients were treated with VAD only. The suppressive immune indexes and clinical curative effect were appraised objectively and the adverse reac- tion was judged by the standand of CTCAE 3.0. Results The suppressive immune indexes and clinical indexes of C-VAD group are clearly better than those of VAD group after the treatment. The total effectrve rate of C-VAD group （79.2 %）, in which the CR （16. 7%）, nCR （25.0%） ,PR （37.5%）, MR （12.5%）, and PD （8. 3%）. The total effectrve rate of VAD group （55.0%）, in which the CR （5.0%）, nCR （15. 0%） ,PR （35.0%） ,MR （25.0%） ,and PD （20. 0%）. There were few adverse reactions in patients of the two groups, which cound be inproved after treatment. Conclusion The C- VAD regimen is safe, reliable and effective treatment for MM.

关 键 词：多发性骨髓瘤 环磷酰胺 免疫功能 

分 类 号：R738.1[医药卫生—肿瘤]