两种治疗方案对老年多发性骨髓瘤的临床疗效  

Clinical Observation of two Treatment Options Regimen in the Treatment of Elderly Patients with Multiple Myeloma

作　　者：徐昕[1] 徐茂忠[1] 戴秋新[1] 赵钰[1] 

机构地区：[1]东南大学医学院附属江阴医院血液科,江苏江阴214400

出　　处：《医学与哲学（B）》2016年第2期27-29,55,共4页Medicine & Philosophy(B)

摘　　要：比较硼替佐米联合地塞米松(BD方案)和沙利度胺联合地塞米松(TD方案)在老年多发性骨髓瘤(MM)治疗的临床疗效及安全性。选择50例老年MM患者随机分为BD组(25例)和TD组(25例),分别接受BD方案治疗和TD方案治疗,4个疗程后评价疗效、不良反应发生情况。经治疗后,BD组和TD组的血红蛋白较治疗前显著升高,β_2微球蛋白、M蛋白、骨髓瘤细胞比例均较治疗前显著下降(P<0.05);治疗后BD组的血清肌酐和骨髓瘤细胞比例均低于治疗后TD组水平(P<0.05)。BD组治疗总有效率为78%,明显高于TD组的52%(P<0.05)。BD治疗组不良反应包括血小板减少、白细胞减少、乏力、外周神经病变,TD组不良反应包括便秘、皮疹、头晕,该7类不良反应发生率两组差异有统计学意义(P<0.05)。BD方案在老年MM治疗中具有更高的有效性和适用性。To evaluate the efficacy and safety between BD regimen and TD regimen in the treatment of multiple myeloma （MM） in elderly patients. 50 elderly patients with MM were enrolled and divided into BD group and TD group. The effective rate and side-effects were assessed after 4 cycles of treatment. After treated with BD regimen or TD regimen, the levels of hemoglobin were increase while 132 micro globulin, M protein, myeloma proportion decreased compared with before （P〈0.05）. The levels of serum certainties after treatment in BD group were significantly lower compared with the before and the later value in TD group （P〈0.05）. Compared with TD group, the myeloma proportion in BD group was much lower （P〈0. 05）. BD regimen had higher effective rate （78%） compared with TD regimen（52%）. The main toxicities were thrombocytopenia, leueopenia, fatigue and peripheral neuropathy in BD group while constipation, skin rashes and dizziness in TD group. The differences of side effects between two groups were statistically significant （P〈 0.05）. BD regime is more effective and suitable for MM treatment in elderly patients.

关 键 词：多发性骨髓瘤 硼替佐米 沙利度胺 

分 类 号：R733.3[医药卫生—肿瘤]