Zhao Yu, Jing Yu, Bo Jian, Li Hong-Hua, Wang Shu-Hong, Huang Wen-Rong, Zhu Hai-Yan, Han Xiao-Ping, Dou Li-Ping, Wang Fei-Fei, Li Fei, Gao Chun-Ji, Wang Quan-Shun, Yu Li
Department of Heamatology, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010 Aug;18(4):1027-30.
The study was aimed to evaluate the adverse effects of PAD (bortezomib + adriamycin + dexamethasone) and VAD (vincristine + adriamycin + dexamethasone) as chemotherapy regimens in multiple myeloma patients. 27 and 30 patients with multiple myeloma (MM) were enrolled in PAD and VAD groups respectively. MM patients accepted 3 - 5 cycles of VAD or PAD regimens. The type, degree and occurrence time of adverse reactions during the treatment were observed. The results showed that the rash was found in two patients only in PAD group, leucocytopenia, thrombocytopenia, peripheral neuropathy, infection, fatigue, nausea, constipation, and adverse effects of cortex hormone (hypertension, glycemia, hypokalemia, hyponatremia and acne) were found in the both two groups. The thrombosis was not observed in both two groups during treatment. Although statistical analysis indicated that only the incidence of thrombocytopenia was higher in PAD group than in VAD group with statistical difference but the incidence of leucocytopenia, peripheral neuropathy and infection in PAD group were higher than those in VAD group. Rash, constipation, peripheral neuropathy could be found in the first course of chemotherapy, while the others mostly emerged after 3 courses of treatment. The main reasons for the patients who's treatment was stopped include infection and intolerable peripheral neuropathy. Although peripheral neuropathy could be found in the two groups, but the chemotherapy was stopped only in 2 patients of PAD group after 3 cycles of treatment. It is concluded that compared with conventional VAD chemotherapy, PAD may improve therapeutic effect, but it may bring more severe toxicities to the patients with multiple myeloma.
本研究旨在评估硼替佐米+阿霉素+地塞米松（PAD）和长春新碱+阿霉素+地塞米松（VAD）作为化疗方案对多发性骨髓瘤患者的不良反应。分别将27例和30例多发性骨髓瘤（MM）患者纳入PAD组和VAD组。MM患者接受3-5个周期的VAD或PAD方案治疗。观察治疗期间不良反应的类型、程度及发生时间。结果显示，仅PAD组有2例患者出现皮疹，两组均出现白细胞减少、血小板减少、周围神经病变、感染、疲劳、恶心、便秘以及皮质激素的不良反应（高血压、血糖升高、低钾血症、低钠血症和痤疮）。治疗期间两组均未观察到血栓形成。虽然统计分析表明仅PAD组血小板减少的发生率高于VAD组，有统计学差异，但PAD组白细胞减少、周围神经病变和感染的发生率高于VAD组。皮疹、便秘、周围神经病变可在化疗的第一个疗程出现，而其他不良反应大多在3个疗程后出现。治疗停止的主要原因包括感染和难以耐受的周围神经病变。虽然两组均能发现周围神经病变，但PAD组仅2例患者在3个周期治疗后停止化疗。结论是，与传统的VAD化疗相比，PAD可能提高治疗效果，但可能给多发性骨髓瘤患者带来更严重的毒性。
