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目的探讨沙利度胺(商品名为反应停)联合VAD方案治疗难治、复发性多发性骨髓瘤(MM)治疗的疗效及不良反应。方法沙利度胺起始剂量为200mg/d,分早、晚二次口服;以后每周增加50mg～100mg,增至300mg/d,维持3个月以上;VAD方案:VCR(长春新硷)1mg+生理盐水20ml静推。ADR(阿霉素)10mg/d+5%葡萄糖250ml静滴,第5～8天Dex(地塞米松30mg/d+生理盐水250ml/静滴第9～12d),2周为疗程。结果CR(完全缓解)1例,PR(部分缓解)6例,MR(进步)2例,NR(未缓解)5例,总有效率64.3%。结论沙利度胺联合VAD方案治疗难治、复发性MM近期疗效较好,不良反应轻。
Objective To investigate the curative effect and adverse reactions of thalidomide combined with VAD regimen in the treatment of refractory and recurrent multiple myeloma (MM). Methods The initial dose of thalidomide was 200mg / d, which was orally administered twice daily in the morning and evening. The dosage of thalidomide was increased from 50mg to 100mg weekly to 300mg / d for more than 3 months. The VAD regimen: VCR (vincristine) 1mg + saline 20ml static push. ADR (doxorubicin) 10mg / d + 5% glucose 250ml intravenous drip, 5 to 8 days Dex (dexamethasone 30mg / d + saline 250ml / intravenous drip 9 ~ 12d), 2 weeks course of treatment. Results CR (complete remission) in 1 case, PR (partial remission) in 6 cases, MR in progress in 2 cases and NR in 5 cases, the total effective rate was 64.3%. Conclusions Thalidomide combined with VAD regimen is refractory to recurrent MM with good short-term efficacy and mild adverse reactions.