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本组病例为:耐药、复发以及未经治疗而有下列三项以上危险因素的患者:1)血清肌酐>20g/dl;2)血小板计数<10万/mm~3;3)血红蛋白<8g/dl;4)血钙>12mg/dl;5)几乎完全或完全卧床不起;6)浆细胞性白血病,外周血分类计数中浆细胞>10％。4周以内接受过化疗或有活动性感染者不包括在内,共65例。环磷酰胺每天600mg/M~2,静脉内1小时滴完,连续4天。病情无恶化者,于第29天重复治疗。所有病人在第一疗程时,不管血细胞计数的情况如何,约给予足量治疗、但第二疗程则可能推迟,待血细胞计数回升至基础水平。那些能耐受治疗且治疗有效的病人,每隔3个月再给予1个疗程。判断疗效的客观标准:血清中M蛋白或24小时尿中的轻链减少50％以上,或可测量的浆细胞瘤的直径的乘积减少50％以上。若治疗前尿中的轻链每24小时
In this group of patients: drug resistance, relapse and untreated patients with the following three risk factors: 1) serum creatinine> 20g / dl; 2) platelet count <100,000 / mm; 3) hemoglobin <8g / dl; 4) calcium> 12mg / dl; 5) almost completely or completely bedridden; 6) plasma cell leukemia, peripheral blood cell count> 10% of the number of plasma cells. Within 4 weeks of chemotherapy or active infection are not included, a total of 65 cases. Cyclophosphamide daily 600mg / M ~ 2, 1 hour intravenous drip finished for 4 days. No deterioration in the condition, repeated treatment on the 29th day. All patients are given adequate treatment at the first course of treatment irrespective of their blood counts, but the second course of treatment may be delayed until the blood count returns to the basal level. Those who can tolerate the treatment and effective treatment, every 3 months to give a course of treatment. Objective criteria to determine the efficacy: serum M protein or 24-hour urinary light chain in more than 50% reduction, or measurable plasmacytoma diameter product of more than 50% reduction. If treatment before light urine in urine every 24 hours