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目的探讨多发性骨髓瘤的临床特征及不同方案的疗效。方法回顾性分析2006年2月-2010年8月110例多发性骨髓瘤的临床特征及治疗情况,对不同方案的疗效进行比较。结果 110例患者中Ⅲ期73例,40例伴发有基础疾病;24例接受MP方案,部分缓解10例,无变化1例,疾病进展8例,总有效率41.7%;其余86例接受联合化学疗法的患者完全缓解18例,部分缓解17例,轻微缓解30例,无变化17例,疾病进展4例,总有效率40.7%;两组总有效率差异无统计学意义(P<0.05)。联合化疗中PAD方案的总有效率最高,为62.5%。110例患者的中位生存期32.6个月,3年生存率为34.5%,加入沙利度胺组,总有效率为35.8%,3年生存率36.5%,联合硼替佐米治疗组总有效率为75%。结论多发性骨髓瘤患者多为晚期,有基础疾病,化疗后易感染,联合化疗组的有效率较MP方案高,但两组的总生存率无差异,加用新药沙利度胺或硼替佐米可以提高有效率。
Objective To investigate the clinical characteristics of multiple myeloma and the efficacy of different regimens. Methods The clinical features and treatment of 110 patients with multiple myeloma from February 2006 to August 2010 were retrospectively analyzed. The curative effects of different regimens were compared. Results Of the 110 patients, 73 were in stage Ⅲ and 40 were associated with underlying disease. Among the 24 patients who received MP regimen, 10 were partially relieved, 1 had no change, 8 had disease progression, with a total effective rate of 41.7%; the remaining 86 received combined Chemotherapy patients were completely relieved in 18 cases, partial remission in 17 cases, slight remission in 30 cases, no change in 17 cases, disease progression in 4 cases, the total effective rate was 40.7%; There was no significant difference between the two groups in total effective rate (P <0.05) . The total effective rate of PAD in combination chemotherapy was the highest, 62.5%. The median survival time of the 110 patients was 32.6 months and the 3-year survival rate was 34.5%. The total effective rate was 35.8% and the 3-year survival rate was 36.5% in the thalidomide group. The total effective rate 75%. Conclusions The patients with multiple myeloma are mostly advanced, have underlying diseases and are easily infected after chemotherapy. The combined chemotherapy is more effective than MP, but there is no difference in the overall survival between the two groups. With the addition of thalidomide or bortezol Rice can improve efficiency.