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[目的]探索治疗复发性、难治性多发性骨髓瘤(MM)的有效方法。[方法]经传统化疗方案和干扰素等治疗后复发、再次治疗困难或无效的MM患者共45例,给予三氧化二砷(As2O3)10mg/d,静脉滴注,第1～28天;地塞米松(DXM)40mg/d,第1～4、9～12、17～20、25～28天;沙利度胺(THL)200mg/d,第1～28天。每4周1个疗程,休息4周,连用2个疗程评价疗效。[结果]95.6%(43/45)患者均有效,其中37.8%(17/45)获PR,57.8%(26/45)获有效。6个月无进展生存率(PFS)和12个月PFS分别为89.3%和73.2%。大部分患者都有不同程度的水钠潴留症状,均未见明显骨髓抑制。[结论]三氧化二砷、沙利度胺和地塞米松联合方案是治疗复发性、难治性MM的有效并安全的方法。
[Objective] To explore an effective method to treat recurrent and refractory multiple myeloma (MM). [Methods] 45 patients with refractory or ineffective MM were treated with traditional chemotherapy regimen and interferon. The patients were treated with As2O3 (10mg / d) intravenously for 1 to 28 days. Dexamethasone DXM) 40mg / d, the first ~ 4,9 ~ 12,17 ~ 20,25 ~ 28 days; thalidomide (THL) 200mg / d, the first ~ 28 days. Every 4 weeks 1 course of treatment, rest for 4 weeks, even with 2 courses evaluation efficacy. [Results] 95.6% (43/45) patients were effective, of which 37.8% (17/45) were PR, 57.8% (26/45) were effective. Six-month progression-free survival (PFS) and 12-month PFS were 89.3% and 73.2%, respectively. Most patients have varying degrees of sodium and water retention symptoms, no significant myelosuppression. [Conclusion] Combination of arsenic trioxide, thalidomide and dexamethasone is an effective and safe method for the treatment of recurrent and refractory MM.