Bladé J, Urbano A, López Guillermo A, Rozman M, Rovira M, Montserrat E, Rozman C
Escuela de Hematología Farreras Valentí, Hospital Clínico y Provincial, Universidad de Barcelona.
Sangre (Barc). 1990 Apr;35(2):93-7.
The results achieved in a series of 63 patients diagnosed of multiple myeloma in one Centre between February 1981 and December 1984 are reported. One patient was in stage IA, 27 in stage II (A, 24; B, 3), and the remaining 35 were in stage III (A, 22; B, 13). The initial therapy consisted of courses of vincristine, cyclophosphamide, melphalan and prednisone combination chemotherapy (VCMP) given every 4th week. Among the 56 patients who were evaluable, 28 (50%) showed objective response, 6 (10.7%) clinical improvement, and therapeutical failure was seen in 14, whereas 8 patients died during the first two months of treatment. The haematological tolerance to VCMP was acceptable, but neurotoxicity due to vincristine appeared in 17.8% of the cases. Thirty-two patients showing resistance to VCMP at any given moment received vincristine, BCNU, adriamycin and prednisone or dexamethasone (VBAP/D) as salvage therapy, only 5 responses (15.6%) being achieved. Only 5 patients are still alive and the median survival of the series is 23 months. Progression of the disease and infections were the major causes of death.
报告了1981年2月至1984年12月期间在一个中心诊断为多发性骨髓瘤的63例患者的治疗结果。1例患者处于IA期，27例处于II期（A期24例，B期3例），其余35例处于III期（A期22例，B期13例）。初始治疗方案为每4周进行一次长春新碱、环磷酰胺、美法仑和泼尼松联合化疗（VCMP）。在可评估的56例患者中，28例（50%）出现客观缓解，6例（10.7%）有临床改善，14例治疗失败，8例患者在治疗的前两个月死亡。对VCMP的血液学耐受性尚可，但17.8%的病例出现了长春新碱引起的神经毒性。32例在任何时候对VCMP耐药的患者接受了长春新碱、卡莫司汀、阿霉素和泼尼松或地塞米松（VBAP/D）作为挽救治疗，仅5例（15.6%）获得缓解。仅5例患者仍存活，该组患者的中位生存期为23个月。疾病进展和感染是主要死因。
