Phillips J K, Sherlaw-Johnson C, Pearce R, Davies J M, Reilly J T, Newland A C, Cawley J C
Department of Haematology, Liverpool University, UK.
Leuk Lymphoma. 1995 May;17(5-6):465-72. doi: 10.3109/10428199509056859.
67 patients with relapsed or resistant multiple myeloma were randomized to receive either VAD (vincristine, doxorubicin, dexamethasone) or MOD (mitozantrone, vincristine, dexamethasone). 12/30 (40%) patients receiving VAD and 15/37 (41%) patients receiving MOD achieved plateaux. The median duration of plateaux was significantly longer on VAD (15 months) than on MOD (8 months). No significant difference in overall survival was seen between the two treatment arms. The only toxicity which was severe in more than 5% of treatment cycles on either treatment arm was myelosuppression. No toxicity was significantly more severe on MOD than VAD. However, hair loss was significantly more severe on VAD than MOD. The frequencies of thrombocytopenia, haematuria and cutaneous toxicity were significantly greater on VAD than on MOD. Raised serum direct bilirubin levels were seen significantly more often on MOD than VAD. MOD and VAD have similar efficacy in relapsed/resistant multiple myeloma. MOD is the less toxic of the two regimens.
67例复发或难治性多发性骨髓瘤患者被随机分为两组，分别接受VAD（长春新碱、阿霉素、地塞米松）或MOD（米托蒽醌、长春新碱、地塞米松）治疗。接受VAD治疗的30例患者中有12例（40%）、接受MOD治疗的37例患者中有15例（41%）病情达到平台期。VAD组平台期的中位持续时间（15个月）显著长于MOD组（8个月）。两个治疗组的总生存期无显著差异。两个治疗组中，超过5%的治疗周期出现的唯一严重毒性反应是骨髓抑制。MOD组的毒性反应并不比VAD组严重。然而，VAD组的脱发比MOD组严重得多。VAD组血小板减少、血尿和皮肤毒性的发生率显著高于MOD组。MOD组血清直接胆红素水平升高的情况比VAD组更常见。在复发/难治性多发性骨髓瘤的治疗中，MOD和VAD疗效相似。两种治疗方案中，MOD的毒性较小。
