中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
9期
823-825
,共3页
朱贵华%李秀梅%庄万传%江亚军%何耀%柴星星
硃貴華%李秀梅%莊萬傳%江亞軍%何耀%柴星星
주귀화%리수매%장만전%강아군%하요%시성성
多发性骨髓瘤%吡柔吡星%长春新碱%沙利度胺%地塞米松
多髮性骨髓瘤%吡柔吡星%長春新堿%沙利度胺%地塞米鬆
다발성골수류%필유필성%장춘신감%사리도알%지새미송
Multiple myeloma%Pirarubicin%Vincristine%Thalidomide%Dexamethasone
目的 探讨改良VTD(长春新碱+吡柔比星+地塞米松)方案联合低剂量沙利度胺治疗初治多发性骨髓瘤(MM)的效果及不良反应.方法 回顾性分析29例初治MM患者采用改良VTD方案联合低剂量沙利度胺治疗的临床资料.改良VTD方案为长春新碱2 mg,第1天静脉注射;吡柔比星20～30mg/d,第1、2天静脉滴注;地塞米松8 mg/d,第1～10天静脉滴注,28 d为1个疗程.4个疗程后评价疗效及不良反应.化疗第1天患者即口服沙利度胺50 mg/d,若能耐受,3d后加至100 mg/d长期维持.结果 完全缓解3例(10.3％)、非常好的部分缓解12例(41.4％)、部分缓解10例(34.5％)、疾病稳定3例(10.3％)、疾病进展1例(3.5％),总有效率为86.2％.主要不良反应为骨髓抑制75.9％ (22/29)、乏力72.4％(21/29)、便秘58.6％(17/29),均可耐受.结论 改良VTD方案联合低剂量沙利度胺有效率高、不良反应小,值得推广应用.
目的 探討改良VTD(長春新堿+吡柔比星+地塞米鬆)方案聯閤低劑量沙利度胺治療初治多髮性骨髓瘤(MM)的效果及不良反應.方法 迴顧性分析29例初治MM患者採用改良VTD方案聯閤低劑量沙利度胺治療的臨床資料.改良VTD方案為長春新堿2 mg,第1天靜脈註射;吡柔比星20～30mg/d,第1、2天靜脈滴註;地塞米鬆8 mg/d,第1～10天靜脈滴註,28 d為1箇療程.4箇療程後評價療效及不良反應.化療第1天患者即口服沙利度胺50 mg/d,若能耐受,3d後加至100 mg/d長期維持.結果 完全緩解3例(10.3％)、非常好的部分緩解12例(41.4％)、部分緩解10例(34.5％)、疾病穩定3例(10.3％)、疾病進展1例(3.5％),總有效率為86.2％.主要不良反應為骨髓抑製75.9％ (22/29)、乏力72.4％(21/29)、便祕58.6％(17/29),均可耐受.結論 改良VTD方案聯閤低劑量沙利度胺有效率高、不良反應小,值得推廣應用.
목적 탐토개량VTD(장춘신감+필유비성+지새미송)방안연합저제량사리도알치료초치다발성골수류(MM)적효과급불량반응.방법 회고성분석29례초치MM환자채용개량VTD방안연합저제량사리도알치료적림상자료.개량VTD방안위장춘신감2 mg,제1천정맥주사;필유비성20～30mg/d,제1、2천정맥적주;지새미송8 mg/d,제1～10천정맥적주,28 d위1개료정.4개료정후평개료효급불량반응.화료제1천환자즉구복사리도알50 mg/d,약능내수,3d후가지100 mg/d장기유지.결과 완전완해3례(10.3％)、비상호적부분완해12례(41.4％)、부분완해10례(34.5％)、질병은정3례(10.3％)、질병진전1례(3.5％),총유효솔위86.2％.주요불량반응위골수억제75.9％ (22/29)、핍력72.4％(21/29)、편비58.6％(17/29),균가내수.결론 개량VTD방안연합저제량사리도알유효솔고、불량반응소,치득추엄응용.
Objective To explore the efficacy and adverse reactions of improved VTD regimen (pirarubicin combined with vincristine and dexamethasone) plus low-dose thalidomide in patients of newly diagnosed multiple myeloma(MM).Methods Twenty-nine cases of newly diagnosed MM were enrolled in this study.The improved VTD regimen was intravenous injection vincristine 2 mg/d on the first day,intravenous drip pirarubicin 20-30 mg/d from the first day to the second day,and intravenous drip dexamethasone 8 mg/d from the first day to the tenth day.Twenty-eight days was one course of treatment.Response and adverse reactions were evaluated after 4 course of treatment.On the first day of chemotherapy,all the patients were orally administered thalidomide 50 mg/d.Three days later,thalidomide was added to 100 mg/d and chronically maintained if toxicities could be tolerated.Results There were 3 cases(10.3％) in complete response,12 cases (41.2％) in very good partial response,10 cases (34.5％) in partial response,3 cases (10.3％) in stable disease,and 1 case(3.5％) in progressive disease.The overall response rate was 86.2％.Main adverse reactions were myelosuppression,asthenia and constipation,all could be tolerated.Conclusion It has significant response rate and less side effects of improved VTD regimen plus low-dose thalidomide for the patients of newly diagnosed multiple myeloma,and deserves further clinical practice.
