作　　者： (黄春晖）;

机构地区： 274300,山东省单县中心医院血液内科

出　　处： 《中国医师进修杂志》

摘　　要： 目的 回顾性分析来那度胺联合环磷酰胺、低剂量地塞米松(RCD方案)治疗多发性骨髓瘤的临床疗效及不良反应.方法 45例多发性骨髓瘤患者按非随机同期对照法分为治疗组(25例)和对照组(20例),分别采用RCD方案和MPT方案治疗.比较两种方案的近期疗效及远期疗效,观察不良反应.结果 治疗组和对照组总有效率、高质量缓解(CR+VGPR)率分别是84.0%(21/25)和65.0%(13/20)(P>0.05),64.0%(16/25)和30.0%(6/20)(P<0.05).复发率和3年总生存率分别是24.0%(6/25)和55.0%(11/20),76.0%(19/25)和45.0%(9/20)(P<0.05).治疗组血小板减少、中性粒细胞减少发生率明显高于对照组,而嗜睡、便秘、水肿等非血液学毒性则显著低于对照组(P<0.05).结论 来那度胺联合环磷酰胺、低剂量地塞米松治疗多发性骨髓瘤疗效好,不良反应小,值得推广应用. Objective To retrospectively analyze the therapeutic effect and adverse reactions of lenalidomide combined with cyclophosphamide and low-dose dexamethasone (RCD) in the treatment of multiple myeloma (MM). Methods Forty-five patients with MM was divided into treatment group (25 cases) and control group (20 cases) according to non-randomized concurrent control method: the former was treated by RCD, and the latter accepted melphalan combined with prednison and thalidomide (MPT). Results The overall response rates (ORR) for the treatment group and the control group were 84.0%(21/25) and 65.0%(13/20)respectively (P > 0.05), and high quality response (CR + VGPR) rates were 64.0%(16/25) and 30.0%(6/20) respectively (P<0.05). The relapse rates and 3-year overall survival rates were 24.0%(6/25) and 55.0%(11/20), 76.0%(19/25) and 45.0%(9/20), respectively (P<0.05). Compared with those of the control group, the incidence of thrombopenia and neutropenia was higher, and treatment-related toxicities were lower in treatment group (P<0.05). Conclusions RCD may be more effective, and adverse reactions can be tolerated. The therapy method is worthy to be recommended.

分 类 号： [Z1]