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目的观察VAD方案联合沙利度胺治疗多发性骨髓瘤的临床疗效和不良反应。方法 16例多发性骨髓瘤患者均用VAD方案联合沙利度胺治疗。沙利度胺起始剂量为100mg/d,每周增加100mg至最大耐受量,除3例增加到最大量600～800mg/d并能坚持服用外,其他均不超过400mg/d。28d为1个周期,治疗2周期后,根据血象、血清M蛋白、血清肌酐、骨髓瘤细胞等指标评价疗效。结果完全缓解4例,部分缓解7例,进步3例,无效1例,总有效率为93.75%(15/16)。主要不良反应有骨髓明显抑制3例,不同程度感染4例,周围神经病变10例,嗜睡12例;便秘7例,头晕6例;皮肤瘙痒伴皮疹3例。耐受较好。结论 VAD方案联合沙利度胺治疗多发性骨髓瘤具有较高疗效和耐受性好的优点,值得临床进一步研究和推广。
Objective To observe the clinical efficacy and adverse reactions of VAD combined with thalidomide in the treatment of multiple myeloma. Methods Sixteen patients with multiple myeloma were treated with VAD regimen combined with thalidomide. Thalidomide starting dose of 100mg / d, 100mg per week to the maximum tolerated dose, except 3 cases increased to a maximum of 600 ~ 800mg / d and can insist on taking the other no more than 400mg / d. 28d for a period of 2 cycles, according to blood, serum M protein, serum creatinine, myeloma cells and other indicators to evaluate the efficacy. Results of complete remission in 4 cases, partial remission in 7 cases, 3 cases of progress, 1 case was ineffective, the total effective rate was 93.75% (15/16). The main adverse reactions were bone marrow significantly inhibited in 3 cases, 4 cases of varying degrees of infection, peripheral neuropathy in 10 cases, drowsiness in 12 cases; constipation in 7 cases, dizziness in 6 cases; skin itching with rash in 3 cases. Well tolerated. Conclusions VAD regimen combined with thalidomide has the advantages of high efficacy and good tolerability in the treatment of multiple myeloma and deserves clinical further study and promotion.