沙利度胺联合MP方案治疗多发性骨髓瘤临床观察(1)
摘要: 目的:观察沙利度胺联合MP方案(MPT)与单用MP方案比较治疗多发性骨髓瘤(MM )的临床疗效及不良反应。方法:治疗组(23例)沙利度胺起始剂量100mg/d,每 1~2周增 加50~100mg,最高剂量为400mg/d并维持治疗,同时联合MP方案化疗,每月1个 疗程。对照 组(22例)单用MP方案化疗。两组在6个疗程后判断疗效。结果:23例治疗组部分缓解14例 (60.9%),进步6例(26.1%),无效 3例(13%),总有效率为87%。22例对照组部分缓解7 例(31.8%),进步 5例(22.7%),无效 10例(45.5%),总有效率54.5%。治疗组疗效比对照 组有显著提高(χ2=6.174,P<0.05)。两组不良反应较轻,两组不良反应比较差异 无统计学 意义(P>0.05)。结论:沙利度胺联合MP方案治疗MM较单用MP方案疗效更明显,不良 反应少,耐受性好,给药方便,尤其适用于老年患者。
关键词:沙利度胺; MP方案;多发性骨髓瘤
, 百拇医药
中图分类号: R730.53; R733.3 文献标识码: A 文章编号: 1008-2409(2009)05-0826-03
Clinical study of the treatment with thalidomide combinated MP protocol on multi p le myeloma/LI Yun∥The First People's Hospital of Qingzhou City, Qingzhou 535000 , China
Abstract:Objective: To investigate the effect and adverse effect of treatmentwith thalidomide combinated MP protocol on multiple myeloma(MM). Methods: Twent y-three patients with MM in treated group were given thalidomide at 100mg a day at first, and added thalidomide to the maintenance dosage of 400mg a day with th e increasing of 50~100mg in one to two weeks. The chemical therapy of MP protoc ol were given at the same time. The course of treatment lasted for one month. Tw enty-two patients were given the chemical therapy of MP protocol only. The eff e ct and adverse effect of treatment had been evalutated after 6 course of treatme nts. Results: In the treated group, fourteen patients got partial remission, sixpatients were improved, and three patients had no effect. The total effective r ate was 87% in the treated group. In the control group, seven patients got parti al remission, five patients were improved, and ten patients had no effect. The t otal effective rate was 54.5% in the control group. Compared with the controlgr oup, therapeutic effect significantly improved in treated group(χ2 =6.174, P<0.0 5), and there was not statistically significant difference between the two gr oups(P>0.05). Conclusion: Effect of treatment with thalidomide combinatedMPprotocol on MM significantly improved than that of the treatment with MP protoco l,and the adverse effect is not increased.
, http://www.100md.com
Key words:thalidomide; MP protocol; multiple myeloma
多发性骨髓瘤是浆细胞恶性增生性疾病,占血液系统恶性肿瘤的10%,MM多发生于中､老年人 。对于年龄大､身体状况欠佳或伴有其他疾病不适合移植的患者,MP方案被认为是诱导治疗 的标准方案,但多次化疗后易产生耐药性,成为难治性复发性MM。根据报告[1]沙利 度胺是一 种血管生成抑制剂,也是一种免疫调节剂,近年来发现它对 MM等多种肿瘤具有抗瘤活性, 并且对难治者､复发者也有效,应用沙利度胺联合化疗治疗难治性MM可取得良好疗效。笔者 回顾性分析我院应用沙利度胺加MP方案治疗MM患者的疗效及不良反应,并与单用MP方案进 行比较,报告如下。
1 资料与方法
1.1 一般资料
45例患者均系2003年 6月至2009年4月我院住院患者, 临床诊断及疗效评定 均按MM诊断及疗效标准进行[2]。随机分为2组。治疗组:23例,男15例, 女8例,初 发13例, 复发10例,年龄48~76岁,中位年龄62岁;病程分期:Ⅱ期14例, Ⅲ期9例;分型: IgG型16例 ,IgA型4例, IgM 型1例,轻链型2例。对照组:22例,男14例,女8例,年龄 49~81岁, 初发 14例,复发8例,中位年龄63岁;其中分期为Ⅱ期13例, Ⅲ期9例;分型: IgG型14例,IgA型4例 ,IgM型3例,轻链型1例。2组在年龄､男女比例､病情等方面差异无统计学意义(P>0.05) ,具有可比性。
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1.2 治疗方法
治疗组:沙利度胺加MP方案: 马法兰 8 mg/m2, 4 d,泼尼松 6 0 mg/m2,4d,每月 1个疗程,自化疗开始起口服沙利度胺片,起始剂量100mg/d,晚一次顿 服,根据耐受情况每 1~2周增加 50~100mg,最高剂量为 400mg/d并维持治疗。对照组:MP 方案(马法兰､泼尼松剂量､用法同治疗组)。两组均在6个疗程后判断疗效。定期检查血 常规､肝肾功能､免疫球蛋白､骨髓象､β-微球蛋白等,注意观察患者的不良反应,如嗜睡 ､腹胀､便秘､口干､头晕乏力等症状。, 百拇医药(李 云)
关键词:沙利度胺; MP方案;多发性骨髓瘤
, 百拇医药
中图分类号: R730.53; R733.3 文献标识码: A 文章编号: 1008-2409(2009)05-0826-03
Clinical study of the treatment with thalidomide combinated MP protocol on multi p le myeloma/LI Yun∥The First People's Hospital of Qingzhou City, Qingzhou 535000 , China
Abstract:Objective: To investigate the effect and adverse effect of treatmentwith thalidomide combinated MP protocol on multiple myeloma(MM). Methods: Twent y-three patients with MM in treated group were given thalidomide at 100mg a day at first, and added thalidomide to the maintenance dosage of 400mg a day with th e increasing of 50~100mg in one to two weeks. The chemical therapy of MP protoc ol were given at the same time. The course of treatment lasted for one month. Tw enty-two patients were given the chemical therapy of MP protocol only. The eff e ct and adverse effect of treatment had been evalutated after 6 course of treatme nts. Results: In the treated group, fourteen patients got partial remission, sixpatients were improved, and three patients had no effect. The total effective r ate was 87% in the treated group. In the control group, seven patients got parti al remission, five patients were improved, and ten patients had no effect. The t otal effective rate was 54.5% in the control group. Compared with the controlgr oup, therapeutic effect significantly improved in treated group(χ2 =6.174, P<0.0 5), and there was not statistically significant difference between the two gr oups(P>0.05). Conclusion: Effect of treatment with thalidomide combinatedMPprotocol on MM significantly improved than that of the treatment with MP protoco l,and the adverse effect is not increased.
, http://www.100md.com
Key words:thalidomide; MP protocol; multiple myeloma
多发性骨髓瘤是浆细胞恶性增生性疾病,占血液系统恶性肿瘤的10%,MM多发生于中､老年人 。对于年龄大､身体状况欠佳或伴有其他疾病不适合移植的患者,MP方案被认为是诱导治疗 的标准方案,但多次化疗后易产生耐药性,成为难治性复发性MM。根据报告[1]沙利 度胺是一 种血管生成抑制剂,也是一种免疫调节剂,近年来发现它对 MM等多种肿瘤具有抗瘤活性, 并且对难治者､复发者也有效,应用沙利度胺联合化疗治疗难治性MM可取得良好疗效。笔者 回顾性分析我院应用沙利度胺加MP方案治疗MM患者的疗效及不良反应,并与单用MP方案进 行比较,报告如下。
1 资料与方法
1.1 一般资料
45例患者均系2003年 6月至2009年4月我院住院患者, 临床诊断及疗效评定 均按MM诊断及疗效标准进行[2]。随机分为2组。治疗组:23例,男15例, 女8例,初 发13例, 复发10例,年龄48~76岁,中位年龄62岁;病程分期:Ⅱ期14例, Ⅲ期9例;分型: IgG型16例 ,IgA型4例, IgM 型1例,轻链型2例。对照组:22例,男14例,女8例,年龄 49~81岁, 初发 14例,复发8例,中位年龄63岁;其中分期为Ⅱ期13例, Ⅲ期9例;分型: IgG型14例,IgA型4例 ,IgM型3例,轻链型1例。2组在年龄､男女比例､病情等方面差异无统计学意义(P>0.05) ,具有可比性。
, http://www.100md.com
1.2 治疗方法
治疗组:沙利度胺加MP方案: 马法兰 8 mg/m2, 4 d,泼尼松 6 0 mg/m2,4d,每月 1个疗程,自化疗开始起口服沙利度胺片,起始剂量100mg/d,晚一次顿 服,根据耐受情况每 1~2周增加 50~100mg,最高剂量为 400mg/d并维持治疗。对照组:MP 方案(马法兰､泼尼松剂量､用法同治疗组)。两组均在6个疗程后判断疗效。定期检查血 常规､肝肾功能､免疫球蛋白､骨髓象､β-微球蛋白等,注意观察患者的不良反应,如嗜睡 ､腹胀､便秘､口干､头晕乏力等症状。, 百拇医药(李 云)