沙利度胺联合地塞米松治疗难治复发性多发性骨髓瘤的临床研究

 目的 探讨沙利度胺联合地塞米松（Thal-Dex）方案治疗难治复发性多发性骨髓瘤（MM）的疗效及相关毒副作用。方法 采用Thal-Dex方案对15例难治复发性MM患者进行治疗，沙利度胺起始剂量为100 mg，维持两周后逐渐增至200 mg；地塞米松片40 mg口服，第1～4天、第9～12天、第17～20天，4周为1疗程；口服小剂量华法林（1.25 mg／d）预防深静脉血栓（DVT），监测骨髓细胞学浆细胞数、血M蛋白、血β2-微球蛋白及其他常规检查项目。结果 15例患者中完全缓解5例，部分缓解4例，微小反应4例，无反应1例，死亡1例，总体反应率为60.0 %；3例患者发生DVT；全部患者未发生Ⅱ级以上血液毒性。结论 Thal-Dex 方案对于难治复发性MM有较好的疗效，耐受性好，但需注意DVT发生。

Clinical study on thalidomide incorporation with dexamethasone in the treatment of refractory or relapsed multiple myeloma

Objective To investigate the retrospective analysis of a cohort of advanced and refractory multiple myeloma (MM) who were treated with thalidomide-dexamathasone (Thal-Dex) to evaluate the effect and side effect of Thal-Dex. Methods 15 patients with advanced and refractory multiple myeloma were treated with Thal-Dex. All of 15 patients were received thalidomide at the starting dose of 100 mg/d for 14 days and then increased to 200 mg/d in two weeks. Pulsed dexamethasone combined with thalidomide was ad－ministered at the dose of 40 mg/d on days 1 to 4, 9 to 12, and 17 to 20 (odd cycles) on each cycles, repeated monthly. Low dose of warfarin (1.25 mg/d) was given for prophylaxis of deep vein thrombosis (DVT). To evalu－ate the effect of Thal-Dex, plasma cell count of bone marrow, serum levels of M protein, β2-microglobulin and other routine examination were monitored. Results Totally, 5 of 15 patients achieved CR, 6 of them got par－tial remission (PR), 2 of them shown minimal response （MR）, 1 has no response （NR）and 1 died. Three of all cases developed DVT and none of 15 cases have grade 3 to 4 toxicities. Conclusion The results of our ret－rospective analysis provided demonstration of the superiority of Thal-Dex in term of response and extent of tu－mor reduction for relapsed and refractory MM. The most common complication of Thal-Dex is DVT.