【摘要】 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 lt;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。
【Abstract】 Objective To analyze the clinical characteristics and clinical outcomes of patients with multiple myeloma treated with different regimens. Methods We retrospectively analyzed the clinical characteristics and treatments of 110 patients with multiple myeloma treated between February 2006 and August 2010, and compared the clinical outcomes of different treatment regimens. Results Seventy-three out of the 110 patients were at stage Ⅲ, and 40 patients had one or two more fundamental diseases. Twenty-two patients received MP regimen, among whom 10 gained partial alleviation, 1 had no change and 8 were aggravated with a total effective rate of 41.7%. Another 86 cases received combination chemotherapy, and among them, 18 gained complete alleviation, 17 attained partial alleviation, 30 achieved mild alleviation, 17 had no change, and 4 were aggravated with a total effective rate of 40.7%. In terms of the total effective rate, there was no statistical difference between these two groups. PAD-treated group had a highest effective rate of 62.5%. The median survival time for all the patients was 32.6 months; 3-year survival rate was 34.5%. For patients treated with thalidomide, the total effective rate and 3-year survival rate were 35.8% and 36.5% respectively, while for patients treated with bortezomib, the effective rate was 75%. Conclusions Patients with multiple myeloma at a late stage complicated with fundamental diseases can develop infections after chemotherapy. Total effective rate of combination chemotherapy is higher than that of MP treatment, but survival rate of the two treatments have no statistical difference. The effective rate can be increased after the using of novel agents such as thalidomide and bortezomib.
Citation： ZOU Wenrong,TONG Hao,XU Fang,PENG Peng. Analysis of Characteristics and Clinical Outcomes of Multiple Myeloma. West China Medical Journal, 2011, 26(9): 1294-1297. doi: Copy