沙利度胺联合MP方案治疗多发性骨髓瘤的疗效评价

目的 比较沙利度胺联合美法仑+泼尼松方案(MPT)与美法仑+泼尼松方案(MP)治疗多发性骨髓瘤(MM)的疗效与患者不良反应.方法 采用回顾性分析,MPT组26例,美法仑每天9 mg/m2口服,第1天至第4天,泼尼松60 mg/m2,第1天至第4天,或者美法仑每天4 mg/m2口服,第1天至第7天;泼尼松每天40 mg/m2口服,第1天至第7天,28 d为1个疗程,沙利度胺白化疗开始持续给药,100～200 mg/d,每4周为1个疗程,MP组21例,美法仑及泼尼松用法用量同MPT组,6个疗程后评价总疗效结果 MPT组的总有效率(ORR)为65.4%,明显高于MP组的42.9%(P＞0.05);MPT组中位反应时间为2个月,MP组为3个月;MPT组患者治疗后血红蛋白及清货白升高明显高于MP组(P＜0.05);MPT组不良反应的发生率高于MP组(P＜0.05),但两组3度以上的不良反应差异无统计学意义;MPT组中位无进展生存时间(PFS)为11个月,2年PFS为66.18%.结论 与MP方案相比,MPT方案可以提高MM患者的有效率,改善生活质量,延长生存时间,耐受性良好.

Efficacy of thalidomide plus MP regimen for treatment of the patients with multiple myeloma

Objective To compare the efficacy and toxicity of melphalan + prednisone + thalidomide regimen (MPT) and melphalan + prednisone regimen (MP) in the treatment of multiple myeloma (MM).was given 100-200 mg/d everyday. 21 cases in MP group, the dose of melphalan and prednisone were the same as that in MPT group. The efficacy was evaluated after 6 cycles of treatment. Results The overall response rate (ORR) of MPT group and MP group were 65.4 % and 42.9 %, respectively (P＞O.05). The median response time in MPT group versus MP group was 2 months versus 3 months. Compared with the MP group. the increase of hemoglobin and albumin concentration in the MPT group is significantly higher (P＜ 0.05).The incidence of adverse effects of MPT group was higher than that of MP group (P ＜0.05), but the percentage of grade 3 and grade 4 toxicity was no different. The median PFS in MPT group was 11 months, 2-year PFS was 66.18 %. Conclusion Compared with MP, MPT could achieve higher response rate, improve the life quality and prolong the survival time of MM patients with better tolerance.