【摘要】 目的观察来那度胺联合VAD方案(长春新碱+多柔比星+地塞米松)治疗多发性骨髓瘤(MM)的临床疗效和不良反应发生情况。方法选择MM患者55例,分为两组。对照组31例单独采用VAD方案,试验组24例采用来那度胺(25 mg,口服,每日1次)+VAD方案联合治疗,28 d为1个疗程。4个化疗周期后进行疗效评价,观察治疗期间不良反应的发生情况。结果试验组有效率80%(19/24),高于对照组52%(16/31),试验组临床疗效优于对照组(P<0.05)。试验组Ⅰ期和Ⅱ期患者有效率均为100%,Ⅲ期患者有效率为29%,对照组分别为82%、62%和11%,同期对比组间差异显著(P<0.05)。两组血液系统损害、肝损害、心血管系统损害、外周神经系统损害、胃肠系统损害、感染性发热的发生率均无显著差异(P>0.05)。结论来那度胺联合VAD方案治疗MM的疗效优于VAD方案单用,对早期患者疗效更明显,不良反应发生率相当。更多还原

【Abstract】 AIM To observe clinical curative effect and occurrence of adverse reactions of lenalidomide combined with VAD regimen(vincristin + doxorubicin + dexamethasone) in the treatment of multiple myeloma(MM). METHODS Fifty-five MM patients were divided into two groups. Thirty-one patients in the control group were treated with VAD regimen alone. And other 24 patients in the trial group were treated with lenalidomide( 25 mg, po, qd) + VAD regimen combination therapy. A course of treatment was 28 d. After 4 cycles of chemotherapy, the curative effect was evaluated. The adverse reactions during chemotherapy were observed.RESULTS The effective rate of the trial group was 80%( 19/24), higher than that of the control group(52%, 16/31, P < 0.05). The clinical efficacy of the trial group was better than that of the control group(P <0.05). In the trail group, the effective rates of patients in stage Ⅰ, Ⅱ and Ⅲ were 100%, 100% and 29%,higher than those in the control group(82%, 62%, and 11% respectively, P < 0.05). There was no significant difference between the incidence of blood system injury, liver injury, cardiovascular system injury, peripheral nervous system injury, gastrointestinal system injury, infectious fever between two groups( P > 0.05).CONCLUSION Lenalidomide combined with VAD regimen in the treatment of MM is better than VAD regimen alone, which is more effective for patients in the early stage, and the incidence of adverse reactions is similar.更多还原