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本组病例29例,中数年龄61岁,72％有中等或巨大瘤块,IgG型12例,IgA型11例,只分泌本-周蛋白者6例、非分泌型与瘤块小而稳定的MM不作为研究对象。采用VAD方案治疗:长春新硷(V)0.4mg/日和羟柔红霉素(A)9mg/M~2/日连续输注4天,每周的第1、9和17天分别开始给予地塞米松(D)40mg/晨×4天。对烷化剂和强的松耐药的20例力组Ⅰ,过去对A组合(如每月一次Ⅴ、环磷酰胺、A和强的松)耐药的9例为组Ⅱ。29例病人中不包括以往曾用过VA和脉冲式的强的松者。血清瘤蛋白消失或其水平稳定有效的病例,在停止治疗前应接受4个追加的VAD疗程。组Ⅰ有14例瘤块缩小3/4以上,有效率为70％。组Ⅱ的有效率23％。有效者瘤块减半中数时间为0.9个月,与VAP有效的1.1个月相似。VAD组Ⅱ3例有效。17例有效病人都有显著的临床症状改善,
The group of patients in 29 cases, the median age of 61 years, 72% had medium or huge tumor mass, IgG type in 12 cases, IgA type in 11 cases, only the secretion of this week protein in 6 cases, non-secreting tumor mass with small and stable MM is not the study object. Treatment with VAD regimen: vincristine (V) 0.4 mg / day and daunorubicin (A) 9 mg / M ~ 2 / day for continuous infusion for 4 days with administration on days 1, 9 and 17 of each week Dexamethasone (D) 40mg / morning × 4 days. For the alkylating agents and prednisolone 20 cases of force group Ⅰ, the past for group A (such as monthly Ⅴ, cyclophosphamide, A and prednisone) resistance in 9 cases of group Ⅱ. 29 patients did not include the past had used VA and pulse-type prednisone. Serum oncoprotein disappeared or its level is stable and effective cases, before stopping treatment should receive four additional VAD courses. Group Ⅰ 14 patients reduced more than 3/4, the effective rate was 70%. The effective rate of group Ⅱ 23%. Effective nodules in half the median time of 0.9 months, and VAP effective 1.1 months similar. VAD group Ⅱ 3 cases effective. Seventeen valid patients had significant clinical improvement,