小剂量沙利度胺联合长春地辛\吡喃阿霉素和地塞米松方案治疗老年多发性骨髓瘤(1)

http://www.100md.com 2010年7月1日 刘海燕

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     【摘要】 目的 分析小剂量沙利度胺联合长春地辛、吡喃阿霉素和地塞米松方案方案,治疗老年多发性骨髓瘤患者临床疗效及不良反应。方法 将我院12例老年多发性骨髓瘤患者,进行小剂量沙利度胺联合长春地辛、吡喃阿霉素和地塞米松方案治疗后,进行临床疗效评价及药物不良分析。结果 12例不同类型的老年多发性骨髓瘤患者治疗后:完全缓解4例占33.3%,部分缓解5例占41.7%,无效3例占25.0%,总有效率为9例占75.0%。所有患者除有少数出现轻微的头昏、乏力、水肿外,余患者均未发生肝肾功能损害、明显骨髓抑制、神经病变、静脉栓塞等不良反应。结论 小剂量沙利度胺联合长春地辛、吡喃阿霉素和地塞米松治疗老年多发性骨髓瘤疗效较好,不良反应轻微,易于耐受。

    【关键词】沙利度胺;长春地辛;吡喃阿霉素;地塞米松;老年多发性骨髓瘤

    Low-dose thalidomide combined vindesine,pirarubicin and dexamethasone in the treatment of elderly multiple myeloma

    LIU Hai-yan.Department of Tumor Branch, the First People’s Hospital of Shangqiu,Henan 476100,China

    【Abstract】 Objective To analyze the low-dose thalidomide combined vindesine,pirarubicin and dexamethasone programs programs,treatment of elderly patients with multiple myeloma clinical efficacy and adverse reactions.Methods 12 cases of elderly hospital patients with multiple myeloma,small-dose thalidomide combined vindesine,pirarubicin and dexamethasone in the treatment was conducted after the evaluation of clinical efficacy and adverse drug analysis.Results 12 patients with different types of elderly patients with multiple myeloma after treatment:complete remission,4 cases accounted for 33.3%,partial remission in 5 cases accounted for 41.7%,3 cases accounted for 25.0%,with a total effective rate of 9 cases accounted for 75.0%.All patientsexcept a few slight dizziness,fatigue,edema,the liver and kidney function than patients with none of the damage occurred,obviously bone marrow suppression,neuropathy,venous thrombosis and other adverse reactions.Conclusion Low-dose thalidomide combined vindesine,pirarubicin and dexamethasone treatment of multiple myeloma aged better,adverse reactions are mild and easy to tolerate.

    【Key words】Thalidomide; Vindesine; pirarubicin; Dexamethasone; Elderly multiple myeloma

    多发性性骨髓瘤(Multiple myeioma,MM)是常见的血液系统恶性肿瘤,好发于老年人群。主要的临床表现包括贫血、肾功能损害、溶骨性破坏、高钙血症等。几乎所有的MM患者均存在分子遗传学的改变,平均生存期3~4年。虽然高剂量化疗后给予自体移植等方法有效提高了缓解率,但大部分老年患者对于高剂量的化疗方案不能耐受。临床研究证实沙利度胺(商品名:反应停)联合VAD方案化疗可提高MM患者缓解率70%~90%^[1]。沙利度胺又名反应停,20世纪50年代曾用作镇静剂,还更多报道用沙利度胺治疗复发难治性多发性骨髓瘤取得满意疗效。现将我院12例老年多发性骨髓瘤患者,进行小剂量沙利度胺联合长春地辛、吡喃阿霉素和地塞米松方案治疗后,临床分析如下 ......

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