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[目的]探讨沙利度胺联合小剂量MP方案化疗治疗老年多发性骨髓瘤的临床疗效及不良反应。[方法]治疗组12例采用沙利度胺联合小剂量MP方案化疗,沙利度胺自化疗开始时给药,剂量200 mg/d分早、晚口服,以后每周加量50 mg,至300 mg~400 mg/d长期治疗。化疗方案采用小剂量MP方案,马法兰6 mg/d,第1~8天,泼尼松50 mg/d,第1~8天,15 d为一个疗程,连续治疗6个疗程。对照组14例,单纯应用小剂量MP方案化疗,方法及药物剂量均同治疗组。[结果]治疗组部分缓解7例,进步3例,无效2例,总有效率83.33%,明显高于对照组(总有效率57.14%)(P<0.01)。治疗组各种疗效指标改善率均优于对照组(P<0.01~P<0.05)。常见不良反应有便秘、腹胀、纳差、头晕、嗜睡及皮疹等,经调整药物剂量或对症治疗后,均可缓解,未出现严重不良反应。[结论]沙利度胺联合小剂量MP方案化疗治疗老年多发性骨髓瘤具有副作用小、耐受性好、疗效明显等优点,对老年多发性骨髓瘤的治疗不失为一个好的治疗方法,值得推广应用。
[Objective] To investigate the clinical efficacy and adverse reactions of thalidomide and low-dose MP regimen in the treatment of elderly multiple myeloma. [Method] Twelve patients in the treatment group were treated with thalidomide combined with low-dose MP regimen. Thalidomide was given from the beginning of chemotherapy. The dose was 200 mg / d in the morning and evening, and then 50 mg to 300 mg ~ 400 mg / d long-term treatment. A small dose of chemotherapy regimen MP program, melphalan 6 mg / d, 1 to 8 days, prednisone 50 mg / d, 1 to 8 days, 15 d for a course of treatment for 6 courses of continuous treatment. The control group of 14 cases, simple application of low-dose MP regimen chemotherapy, methods and drug doses were the same treatment group. [Results] The treatment group partially relieved 7 cases, advanced 3 cases, invalid 2 cases, the total effective rate was 83.33%, significantly higher than the control group (total effective rate 57.14%) (P <0.01). The improvement rates of various curative indexes in the treatment group were better than those in the control group (P <0.01 ~ P <0.05). Common adverse reactions are constipation, abdominal distension, anorexia, dizziness, drowsiness and rash, etc., after adjustment of the drug dose or symptomatic treatment, can be alleviated, no serious adverse reactions. [Conclusion] The combination of thalidomide and low-dose MP regimen in the treatment of elderly multiple myeloma has the advantages of small side effects, good tolerance and obvious curative effect, which is a good treatment for elderly multiple myeloma, which is worthy of promotion application.