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目的:探讨酞咪哌啶酮(thalidomide,商品名反应停)联合化疗初治多发性骨髓瘤(multiplemyeloma,MM)的初步疗效。方法:治疗组14例初治多发性骨髓瘤应用反应停起始剂量100mg/d~200mg/d,每2周增加100mg~200mg直到患者能够耐受,最大剂量不超过600mg/d,同时联合以马法兰为主的MP或M2方案化疗;对照组20例初治多发性骨髓瘤单用MP或M2方案化疗。观察比较两组的3个月有效率、1年无事件生存率(EFS)和2年总生存率(OS)。结果:有效(部分缓解加进步)率治疗组为85.7%,对照组为50%。1年EFS治疗组为71.4%,对照组为35%。2年OS治疗组为57.1%,对照组为25%。反应停治疗组副作用可以耐受,便秘最常见。结论:反应停联合化疗可提高初治MM的疗效和1年EFS、2年OS。
Objective: To investigate the preliminary efficacy of thalidomide combined with chemotherapy in the treatment of multiple myeloma (MM). Methods: The treatment group of 14 patients with newly diagnosed multiple myeloma response to stop the initial dose of 100mg / d ~ 200mg / d, 100mg ~ 200mg every 2 weeks until the patient can tolerate the maximum dose of not more than 600mg / d, combined with Melphalan-based MP or M2 chemotherapy; control group of 20 newly diagnosed multiple myeloma alone MP or M2 chemotherapy. The three months’ efficiency, one-year event-free survival (EFS) and 2-year overall survival (OS) were compared between the two groups. Results: The effective (partial response plus progress) rate was 85.7% in the treatment group and 50% in the control group. The 1-year EFS treatment group was 71.4% and the control group was 35%. The 2-year OS treatment group was 57.1% and the control group was 25%. Response side effects of treatment group can be tolerated, the most common constipation. Conclusion: Chemotherapy combined with thalidomide can improve the curative effect of MM and 1-year EFS and 2-year OS.