ABSTRACT
Objective To analyze the clinical efficacy and safety of thalidomide combined with VAD regimen (vincristine+epirubicin+dexamethasone) or VAD regimen alone in treatment of multiple myeloma (MM) by using metaˉanalysis. Methods Thalidomide combined with VAD regimen was selected as the experimental group and VAD regimen alone was selected as the control group. The literatures were searched from CNKI, Wanfang and VIP database. And then the inclusive literatures were further searched. Randomized controlled trials eligible to the exclusive criteria were extracted, and the quality was evaluated. Metaˉanalysis was conducted by using Stata14.0 software. Results A total of 17 studies and 940 patients were included. The experimental group had a higher total effective rate compared with the control group , and the difference was statistically significant ( RR＝ 1.41, 95% CI 1.30-1.59, P< 0.01). Meanwhile, the experimental group had a better efficacy in improving hemoglobin and deducing βˉmacroglobulin (MG), M protein and myeloma cells compared with the control group; however, the experimental group also had a worse gastrointestinal reaction, and the difference was statistically significant ( RR＝ 1.36, 95% CI 1.04-1.78, P＝ 0.024). Conclusion Thalidomide combined with VAD regimen in treatment of MM has a better clinical efficacy compared with VAD regimen alone, but it also has a worse adverse reaction.
ABSTRACT
Objective To study curative efficacy of cyclophosphamide combined with VAD regimen in treatment of multiple myeloma and its effects on coagulation function.Methods 78 patients of multiple myeloma who received therapy from July 2013 to July 2016 in our hospital were selected as research objects, and divided into the control group and the observation group , the control group was treated with VAD regimen, while the observation group was treated with cyclophosphamide combined with VAD regimen.Then coagulation factor and anti-coagulation factor activity, adverse reaction, therapeutic effect after treatment between two groups were compared.Results After treatment, decreased blood coagulation factor, Protein C, protein S and antithrombin were increased between two groups , the difference was not statistically significant.Incidence of adverse reactions in observation group was less than the control group[15.38%(6/39)vs 46.15%(18/39)], the difference was statistically significant(P<0.05);The total effective rate of observation group was statistically higher than that in the control group [ 89.74%( 35/39 ) vs 58.97%( 23/39 ) ] , the difference was statistically significant(P<0.05).Conclusion Cyclophosphamide combined with VAD regimen is well for multiple myeloma, which can effectively improve the patient's condition, improve the life quality of patients, and will not cause a greater impact on blood coagulation function.
ABSTRACT
Objective To evaluate the effect and side-effect in patients with multiple myeloma by the treatment of T-VAD.Methods To observe the effect and side-effect in 23 newly diagnosed patients with the treatment of T-VAD,and analyze them.Results Out of 23 patients,9(39%)patients gained complete remission(CR)and 11(49%)achieved partial remission(PR).The median survival time was 46 months.The side-effects consisted of fatigue(100%),somnolence(78%),constipation(69%),infection(48%),secondary diabetes mellitus(30%),numbness(17%),leukopenia(22%)and no one patient experienced deep vein thrombosis(DVT).Disease free survival of three years was 50%.Conclusion The treatment 0f T-VAD on patients with MM is an effective regimen,though there are many side-effcts,such as infection,they are relatively well-tolerated.