Koskela K, Pelliniemi T T, Remes K
Turku University Central Hospital, Department of Medicine, Finland.
Leuk Lymphoma. 1993 Jul;10(4-5):347-51. doi: 10.3109/10428199309148559.
The VAD regimen is effective in the treatment of resistant and relapsing multiple myeloma. In the original VAD regimen, vincristine (V) and doxorubicin (A) are given as continuous infusions together with peroral dexamethasone (D). For practical reasons, we have shortened the infusion times: 8 hours for vincristine and 1 hour for doxorubicin. In this retrospective analysis, we have compared the efficacy and toxicity of the original and modified VAD protocols in the treatment of myeloma patients at our institution. Of the 31 consecutive patients with myeloma, primarily or secondarily resistant to alkylating agents, 16 were treated by the original and 15 by the modified VAD protocol. We found no significant difference in the response rates (good responses 31% and 20% respectively), survival times (17 and 9 months respectively) or toxicity between the two protocols. VAD may well be modified so as to consist of short infusions of V and A. The overall efficacy of the traditional and modified regimens is, however, rather unsatisfactory in patients with advanced myeloma.
VAD方案在难治性和复发性多发性骨髓瘤的治疗中有效。在最初的VAD方案中，长春新碱（V）和阿霉素（A）与口服地塞米松（D）一起持续输注。出于实际原因，我们缩短了输注时间：长春新碱为8小时，阿霉素为1小时。在这项回顾性分析中，我们比较了我院原始和改良VAD方案在治疗骨髓瘤患者中的疗效和毒性。在31例对烷化剂原发或继发耐药的连续骨髓瘤患者中，16例采用原始VAD方案治疗，15例采用改良VAD方案治疗。我们发现两种方案在缓解率（分别为31%和20%）、生存时间（分别为17个月和9个月）或毒性方面没有显著差异。VAD方案可以很好地进行改良，使其由V和A的短时间输注组成。然而，传统方案和改良方案对晚期骨髓瘤患者的总体疗效相当不理想。
