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作者以强烈化疗加自体骨髓移植(ABMT)治疗多发性骨髓瘤取得了前所未有的疗效,制定了完全缓解(CR)的标准.50例初治病人,男33例、女17例,年龄30-69岁,治疗分两步进行.首先24小时持续静脉输注长春新碱、阿霉素4天和每天一次甲基泼尼松龙静注或口服5天(VAMP),3周为一治疗周期,直到M-蛋白在电泳中不能测出或连续二疗程仍稳定止,共用1-11(中位数5)个疗程.然后在VAMP结束6-8周时用大剂量马法兰(HDM)作强烈化疗,11例瘤细胞骨髓浸润大于30%者不作ABMT,剂量为140mg/m~2,28例瘤细胞小于30%者剂量为200mg/m~2,随后作ABMT.疗效标准 CR必须具备下列4项:1.血清中检测不到副蛋白;2.尿中查不到本一周蛋白;3.骨髓中形态正常的浆细胞≤5%;4.以上三项至少持续三个月.部分缓解:副蛋白或骨髓浸润减少50%,持续
The authors have achieved unprecedented treatment with multiple myeloma by intensive chemotherapy combined with autologous bone marrow transplantation (ABMT) and have established a standard of complete remission (CR) .50 cases of newly diagnosed patients, 33 males and 17 females, aged 30- 69 years old, the treatment in two steps.First, 24 hours continuous intravenous infusion of vincristine, doxorubicin 4 days and once daily methylprednisolone or oral 5 days (VAMP), 3 weeks for a treatment cycle , Until the M-protein can not be detected in the electrophoresis or two consecutive courses of treatment is still stable, sharing 1-11 (median 5) course of treatment and then 6-8 weeks after the end of VAMP with high dose of melphalan (HDM) as strong Chemotherapy, 11 cases of bone marrow infiltration of tumor cells more than 30% without ABMT, a dose of 140mg / m ~ 2,28 cases of tumor cells less than 30% at a dose of 200mg / m ~ 2, followed by ABMT.Efficacy CR standards must have the following 4 Items: 1. No detectable paraprotein in serum; 2. No primary protein in urine; 3. Normal plasma cells in bone marrow ≤5%; 4. The above three items last for at least three months. Partial remission: Subprotein or bone marrow infiltration decreased by 50%, sustained