Analysis of Characteristics and Clinical Outcomes of Multiple Myeloma_West China Medical Journal

Authors：

ZOU Wenrong ¹ , TONG Hao ² , XU Fang ³ , PENG Peng ¹

1. Department of Hematology, the 404 Hospital of Mianyang, MianYang, Sichuan 621000, P. R. China; 2. Department of Hematology, the Third People′s Hospital of Mianyang, Sichuan 621000, P. R. China; 3. Department of Hematology, the Central Hospital of Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

Keywords：

多發性骨髓瘤; 臨床特征; 聯合化學療法; 療效

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【摘要】　目的　探討多發性骨髓瘤的臨床特征及不同方案的療效。　方法　回顧性分析2006年2月-2010年8月110例多發性骨髓瘤的臨床特征及治療情況，對不同方案的療效進行比較。　結果　 110例患者中Ⅲ期73例，40例伴發有基礎疾病；24例接受MP方案，部分緩解10例，無變化1例，疾病進展8例，總有效率41.7%；其余86例接受聯合化學療法的患者完全緩解18例，部分緩解17例，輕微緩解30例，無變化17例，疾病進展4例，總有效率40.7%；兩組總有效率差異無統計學意義（P lt;0.05）。聯合化療中PAD方案的總有效率最高，為62.5%。110例患者的中位生存期32.6個月，3年生存率為34.5%，加入沙利度胺組，總有效率為35.8%，3年生存率36.5%，聯合硼替佐米治療組總有效率為75%。　結論　多發性骨髓瘤患者多為晚期，有基礎疾病，化療后易感染，聯合化療組的有效率較MP方案高，但兩組的總生存率無差異，加用新藥沙利度胺或硼替佐米可以提高有效率。
【Abstract】　Objective　 To analyze the clinical characteristics and clinical outcomes of patients with multiple myeloma treated with different regimens. 　Methods　 We retrospectively analyzed the clinical characteristics and treatments of 110 patients with multiple myeloma treated between February 2006 and August 2010, and compared the clinical outcomes of different treatment regimens.　Results　 Seventy-three out of the 110 patients were at stage Ⅲ, and 40 patients had one or two more fundamental diseases. Twenty-two patients received MP regimen, among whom 10 gained partial alleviation, 1 had no change and 8 were aggravated with a total effective rate of 41.7%. Another 86 cases received combination chemotherapy, and among them, 18 gained complete alleviation, 17 attained partial alleviation, 30 achieved mild alleviation, 17 had no change, and 4 were aggravated with a total effective rate of 40.7%. In terms of the total effective rate, there was no statistical difference between these two groups. PAD-treated group had a highest effective rate of 62.5%. The median survival time for all the patients was 32.6 months; 3-year survival rate was 34.5%. For patients treated with thalidomide, the total effective rate and 3-year survival rate were 35.8% and 36.5% respectively, while for patients treated with bortezomib, the effective rate was 75%.　Conclusions　 Patients with multiple myeloma at a late stage complicated with fundamental diseases can develop infections after chemotherapy. Total effective rate of combination chemotherapy is higher than that of MP treatment, but survival rate of the two treatments have no statistical difference. The effective rate can be increased after the using of novel agents such as thalidomide and bortezomib.

Citation： ZOU Wenrong,TONG Hao,XU Fang,PENG Peng. Analysis of Characteristics and Clinical Outcomes of Multiple Myeloma. West China Medical Journal, 2011, 26(9): 1294-1297. doi: Copy

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1. 　張之南, 沈悌. 血液病診斷及療效標準[M]. 3版. 北京: 科學出版社, 2007: 232-235.
2. 　鄧家棟. 臨床血液學[M]. 上海: 上海科學技術出版社, 2001: 1085-1098.
3. 　中國多發性骨髓瘤工作組. 中國多發性骨髓瘤診治指南[J]. 中華內科雜志, 2008, 47(10): 869-872.
4. 　Rajkumar SV, Gerta MA, Kyle RA, et al. Current therapy for multiple myeloma[J]. Mayo Clin Proc, 2002, 77(8): 812-813.
5. 　Myeloma Triaists’Collaborative Group. Combination chemotherapy vesus melphalan plus prednisone as treatment for multiple myeloma: an overview of 6633 patients from 27 randomized trials[J]. J Clin Oncol, 1998, 16(12): 3832-3842.
6. 　鄒文蓉, 彭鵬, 房亞萍. 藥物療法聯合治療多發性骨髓瘤臨床觀察[J]. 臨床薈萃, 2007, 22(1): 52-53.
7. 　Singhal S, Mehta J. Novel theraphy in multiple myeloma[J]. Int J Hematol, 2003, 77: 226-237.
8. 　Weber DM. Newly diagnosed multiple myeloma[J]. Curr Treat Options Oncol, 2002(3): 235-245.
9. 　吳曉雄, 于力, 黃文榮, 等. 硼替佐米治療難治復發性多發性骨髓瘤的療效觀察[J]. 臨床血液學雜志, 2007, 20(5): 268-269.
10. 　Harousseau JL, Attal M, Leleu X, et al. Bortezomib plus dexamethasone as induction treatment prior to autologous stemcell transplantation in patients with newly diagnosed multiple myeloma: results of an IFM phase Ⅱstudy[J]. Haematologica, 2006, 91(111): 1498-1505.
11. 　陳晨, 趙川莉, 侯明, 等硼替佐米為主方案治療多發性骨髓瘤患者的臨床研究[J] 中華血液學雜志, 2011, 32(4): 265-267.
12. 　National Comprehensive Cancer Network(NCCN). NCCN clinical practice guidelines in oncology-multiple myeloma(2009V3)[EB/OL]. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.

West China Medical Journal

Analysis of Characteristics and Clinical Outcomes of Multiple Myeloma

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