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[目的]观察沙利度胺联合MP化疗方案治疗初治多发性骨髓瘤的疗效和不良反应。[方法]2004年2月至2007年1月,47例初治多发性骨髓瘤患者随机分为治疗组(n=23)和对照组(n=24)。两组患者均接受6～8周期的MP方案化疗,治疗组化疗同时接受沙利度胺口服治疗。[结果]治疗组和对照组的总有效率分别是78.3%vs50.0%(P=0.044)。两组2、3年无进展生存率及中位无进展生存时间分别是55.9%vs45.8%、21.0%vs4.2%、27个月vs23个月(P=0.048)。两组2、3年总生存率及中位生存时间分别是86.5%vs83.3%、73.7%vs48.4%、42个月vs33个月(P=0.039)。治疗组血液学毒性和肢体麻木发生率均显著性高于对照组(P<0.05)。[结论]沙利度胺联合MP方案化疗能提高初治多发性骨髓瘤患者的生存率,延长疾病进展时间;不良反应有所增加,但能耐受。
[Objective] To observe the efficacy and adverse reactions of thalidomide combined with MP chemotherapy in the treatment of newly diagnosed multiple myeloma. [Methods] From February 2004 to January 2007, 47 patients with newly diagnosed multiple myeloma were randomly divided into treatment group (n = 23) and control group (n = 24). Two groups of patients received 6 to 8 cycles of MP regimen chemotherapy, while the treatment group received oral thalidomide chemotherapy. [Results] The total effective rates of the treatment group and the control group were 78.3% vs 50.0% (P = 0.044). The two and three-year progression-free survival and median progression-free survival were 55.9% vs45.8%, 21.0% vs4.2%, 27 months vs23 months, respectively (P = 0.048). The 2 and 3-year overall and median survival rates were 86.5% vs83.3%, 73.7% vs48.4%, 42 months vs33 months, respectively (P = 0.039). Hematological toxicity and limb numbness in treatment group were significantly higher than those in control group (P <0.05). [Conclusion] Thalidomide combined with MP regimen can increase the survival rate of patients with newly diagnosed multiple myeloma and prolong the time of disease progression. Adverse reactions increase, but can tolerate.