摘要
目的探讨BD方案联合环磷酰胺、吡柔比星治疗难治性多发性骨髓瘤患者的临床效果。方法选取难治性多发性骨髓瘤患者70例,按随机数字表法分为观察组与对照组,每组35例。在给予支持治疗的基础上,对照组患者采用BD方案治疗;观察组患者在对照组治疗的基础上联合环磷酰胺、吡柔比星治疗。治疗28 d为1个疗程,治疗4个疗程后比较两组患者的临床疗效、不良反应发生率、总生存率与平均生存时间。结果观察组患者的临床疗效ORR(85.71%)显著高于对照组患者(62.86%),差异有统计学意义(P<0.05)。观察组患者感染总发生率(40.0%)显著高于对照组(17.1%),胃肠道反应总发生率(37.14%)显著高于对照组(14.29%),差异有统计学意义(P<0.05),但患者均可耐受,处理后缓解,不影响治疗。kaplan-meier生存分析结果显示,观察组患者平均生存(22.84±4.22)个月,对照组(20.78±3.61)个月,两组比较差异有统计学意义(P<0.05)。结论 BD方案联合环磷酰胺、吡柔比星治疗难治性多发性骨髓瘤患者疗效确切,可延长患者生存期,患者耐受性较好,具有一定的临床推广应用价值。
Objective To investigate the clinical application efficacy of BD regimen combined with cyclophosphamide and pirarubicin in treatment of patients with refractory multiple myeloma. Methods A total of 70 cases of refractory multiple myeloma patients were selected and divided into observation group and control group according to random number table method, with 35 cases in each group. The control group was received BD regimen on the basis of supportive care ,while the observation group was combined cyclophosphamide and pirarubicin treatment on the basis of the therapeutic method of control group. 28 days as one course of treatment,After 4 courses treatment, the total response rate （ORR）, incidence of adverse reactions, overall survival and mean survival time were compared between two groups. Results The ORR of observation group （85.71% ） was significantly higher thancontrol group （62.86%） ,with statistical significance （P〈0.05）. The total infective incidence of observation group （40.0%） was significantly higher than control group （17.1%） , the total incidence of gastrointestinal reactions of observation group （37.14%） was significantly higher than control group （14.29%） ,with statistical significance （P〈0.05）. However, all patients could be tolerated and relieved after treatment ,without affecting the treatment. Kaplan-meier survival analysis indicated that the mean survival time in observation group was （22.84±4.22） months, （20.78 ±3.61 ） months in control group, the difference was statistically significant （P〈0.05）. Conclusion The BD regimen combination with cyclophosphamide and pirarubicin in treatment of refractory multiple myeloma can improve the efficacy and extend overall survival of patients,which is well tolerated and worthy of promoting.
作者
林薇
邓丽贞
司艳辉
LIN Wei;DENG Lizhen;SI Yanhui(Zhaoqing First People＇s Hospital,1 Department of Hematology;Department of Nephrology,Guangdong 526000,China)
出处
《内科》
2018年第4期584-587,共4页
Internal Medicine
