VTD方案与VCD方案治疗原发系统性轻链型淀粉样变的疗效和安全性比较  

Comparison of efficacy and safety of VTD regimen and VCD regimen in the treatment of primary systemic amyloidosis

作　　者：魏妍 陈丹丹[1] 汤平[1] 谢新生[1] WEI Yan;CHEN Dandan;TANG Ping;XIE Xinsheng(Department of Hematology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血液科,河南郑州450052

出　　处：《肿瘤基础与临床》2020年第3期191-195,共5页journal of basic and clinical oncology

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ2018016)。

摘　　要：目的比较VTD(硼替佐米+沙利度胺+地塞米松)方案与VCD(硼替佐米+环磷酰胺+地塞米松)方案作为原发系统性轻链型淀粉样变初治方案的疗效和安全性。方法收集2012年1月至2019年8月在我院确诊并治疗3周期及以上的原发系统性轻链型淀粉样变患者30例,其中VTD组16例(接受VTD方案治疗)、VCD组14例(接受VCD方案治疗)。比较3周期化疗后2组患者血液学缓解率及不良反应发生情况。结果VTD组血液学缓解率低于VCD组(68.8%vs 85.7%),但差异无统计学意义(P>0.05);不良反应发生情况VCD组感染、粒细胞减少、血小板减少发生率均高于VTD组,差异均有统计学意义(85.7%vs 31.3%、42.9%vs 6.2%、50.0%vs 6.2%,P均<0.05);2组贫血、便秘、带状疱疹、周围神经病变发生率比较差异均无统计学意义(P均>0.05)。结论VTD方案和VCD方案对于原发系统性轻链型淀粉样变的临床疗效基本一致,但VCD方案的感染、血液学毒性等不良反应较重。Objective To compare the efficacy and safety of VTD regimen(bortezomib+thalidomide+dexamethasone)and VCD regimen(bortezomib+cyclophosphamide+dexamethasone)in the initial treatment of primary systemic amyloidosis.Methods From January 2012 to August 2019,30 patients with primary systemic amyloidosis diagnosed and treated in our hospital for 3 cycles or more were collected.There were 16 patients in the VTD group and 14 patients in the VCD group.The hematological remission rate and adverse reactions were compared between the two groups.Results The hematological remission rate of the VTD group was lower than that of the VCD group,but the difference was not significant(68.8%vs 85.7%,P>0.05).Adverse reactions:the incidences of chromogenic,granulocytopenia and thrombocytopenia in the VTD group were higher than those in the VTD group,the difference was significant(85.7%vs 31.3%,42.9%vs 6.2%,50.0%vs 6.2%;P<0.05);there was no significant difference in the incidence of anemia,constipation,herpes zoster and peripheral neuropathy between the two groups(P>0.05).Conclusion There is no significant difference in the treatment of primary systemic amyloidosis between the VTD regimen and the VCD regimen.The incidence of infection and hematological toxicity of the VCD regimen were higher than those of the VTD regimen.

关 键 词：原发系统性轻链型淀粉样变 硼替佐米 环磷酰胺 沙利度胺 地塞米松 

分 类 号：R733.1[医药卫生—肿瘤]