小剂量沙利度胺联合VAD化疗对多发性骨髓瘤的治疗效果及安全性观察  

Treatment Effects of Low-dose Thalidomide Combined with VAD Chemotherapy on Multiple Myeloma and Its Safety

作　　者：阳梅[1] 刘志刚[1] 罗玉勤[1] 何川[1] YANG Mei;LIU Zhi-gang;LUO Yu-qin;HE Chuan(Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院血液内科,成都610041

出　　处：《临床误诊误治》2020年第7期35-38,共4页Clinical Misdiagnosis & Mistherapy

基　　金：四川省科技计划项目(2019YFS0104)。

摘　　要：目的研究小剂量沙利度胺联合VAD化疗对多发性骨髓瘤(multiple myeloma, MM)的治疗效果及安全性。方法选取我院2016年12月-2017年12月收治的80例MM患者,按治疗方法的不同均分为观察组(予小剂量沙利度胺+VAD化疗)和对照组(仅予VAD化疗)。比较两组治疗前、治疗12个月后血M蛋白、骨髓浆细胞比例、血红蛋白及血浆血管内皮生长因子(VEGF)水平,治疗效果及不良反应发生情况。结果治疗后,两组血M蛋白、骨髓浆细胞比例及血浆VEGF水平均较治疗前显著下降,血红蛋白水平较治疗前显著上升,差异有统计学意义(P<0.05);且治疗后观察组血M蛋白、骨髓浆细胞比例及血浆VEGF水平显著低于对照组,血红蛋白水平显著高于对照组,差异有统计学意义(P<0.05或P<0.01)。观察组治疗有效率为57.5%高于对照组的15.0%(χ2=15.63,P<0.001)。两组嗜睡、下肢水肿、消化道症状、皮疹、周围神经炎、血液毒性发生率比较差异无统计学意义(P>0.05)。结论小剂量沙利度胺联合VAD化疗能有效改善MM患者血液相关指标,提高治疗效果,且不增加药物不良反应。Objective To study the treatment effects of low-dose thalidomide combined with VAD chemotherapy on multiple myeloma(MM) and its safety. Methods A total of 80 MM patients admitted to our hospital from December 2016 to December 2017 were enrolled and divided into observation group(low-dose thalidomide +VAD chemotherapy, n=40) and control group(VAD chemotherapy alone, n=40) by different treatment methods. The blood M protein, ratio of bone marrow plasma cells, hemoglobin and plasma vascular endothelial growth factor(VEGF), treatment effects and occurrence of adverse reactions were compared between the two groups before treatment and at 12 months after treatment. Results After treatment, the blood M protein, ratio of bone marrow plasma cells and level of plasma VEGF in the two groups were significantly lower than those before treatment while the hemoglobin level was significantly higher than that before treatment(P<0.05). The blood M protein, ratio of bone marrow plasma cells and level of plasma VEGF after treatment in observation group were significantly lower than those in control group while the hemoglobin level was significantly higher than that in control group(P<0.05 or P<0.01). The response rate in observation group was higher than that in control group(57.5% vs 15.0%)(χ2=15.63, P<0.001). There were no significant differences in the incidence rates of complications such as drowsiness, lower extremity edema, gastrointestinal symptoms, skin rash, peripheral neuritis and hematotoxicity between the two groups(P>0.05). Conclusion Low-dose thalidomide combined with VAD chemotherapy can effectively improve the blood-related indicators and enhance the treatment effects of MM patients. In addition, it does not increase the adverse drug reactions.

关 键 词：多发性骨髓瘤 沙利度胺 长春新碱 阿霉素 地塞米松 血管内皮生长因子 药物毒性 

分 类 号：R733.3[医药卫生—肿瘤]