Troussard X, Bauduer F, Leporrier M
Service d'hématologie clinique, CHRU Clemenceau, Caen, France.
Bull Cancer. 1992;79(3):231-42.
The therapeutic strategy in multiple myeloma depends on age and tumor mass. Stage I must not be treated. The Melphalan Prednisone regimen is the reference for induction therapy because polychemotherapies are generally not superior. At this phase, the addition of Interferon alpha seems to be interesting. This drug has an important role during the steady-state phase. VAD represents the most efficient chemotherapy. Body hemi-irradiation is also useful. The analgesic effect and the decrease in the tumoral mass are the striking effects of this treatment. In young patients, high dose chemotherapy with bone marrow transplantation is proposed. Verapamil and anti-IL6 antibodies are currently being evaluated. Symptomatic treatment is essential in this non curable disease.
多发性骨髓瘤的治疗策略取决于年龄和肿瘤大小。I期患者无需治疗。美法仑泼尼松方案是诱导治疗的参考方案,因为多药联合化疗通常并不更具优势。在此阶段,添加α干扰素似乎很有意义。这种药物在稳定期起着重要作用。VAD是最有效的化疗方案。半身放疗也很有用。这种治疗的显著效果是止痛和肿瘤肿块缩小。对于年轻患者,建议进行高剂量化疗并联合骨髓移植。目前正在评估维拉帕米和抗IL-6抗体。对于这种无法治愈的疾病,对症治疗至关重要。