Abstract:

Abstract:Objective To compare the therapeutic efficacy and adverse effects of melphalan and prednisone plus thalidomide regimen ( MPT ) with melphalan and prednisone regimen ( MP ) in the treatment of patients with multiple myeloma ( MM ).Methods 37 elderly patients  newly diagnosed as MM  were treated with MPT or MP.The patients were divided into two groups according to the treatment regimen.MPT group (20 patients):  melphalan 4 mg.m-2?d-1, d 1-7
, prednisone 40 mg?m-2?d-1, d 1-7,thalidomide 100-200 mg?d-1,every 28 d for 1 cycle.MP group (17 patients): the doses of melphalan and prednisone were the same as that in MPT group.The efficacy was evaluated after 4-6 cycles of treatment.Results The overall response rate (ORR ) of the patients in MPT group was significantly higher than that in MP group (65% vs 41.2%，P<0.05). The median time to response in MPT group was shorter than that in MP group (2 months vs 3.5 months，P<0.05).The incidence of grade Ⅰ-Ⅱ side effects in MPT group was
higher than that in MP group (50% vs 24%, P<0.05).However, there was no difference in the incidence of grade Ⅲ-Ⅳ side effects between two groups.Conclusion Compared with  MP regimen, the ORR of MPT is significantly increased, the time of response to treatment is markedly shorten.The incidence of adverse reactions is higher in MPT group, but there is no difference in the incidence of grade Ⅲ-Ⅳ side effects between MPT group and MP group, and the patients can tolerate  well.

Key words: multiple myeloma , thalidomide, elderly patient