Clinical Study On Thalidomide In The Treatment Of Multiple Myeloma

Objectives To evaluate the clinical effectivenesses and side-effects of thalidomide alone or combined with VAD chemotherapy in the treatment of multiple myeloma(MM), and to evaluate the levels of the serum VEGF and the bone marrow microvessel dentity (MVD) of patients with MM before and after the treatment with thalidomide. Methods there were twelve men in thalidomide alone group, which doses were between 400 mg. d^-1 and 800 mg. d^-1。In combination group, 20 patients of MM were received the treatment of thalidomide combined with the standard VAD chemotherapy, the dosage of thalidomide was between 300 mg. d^-1 and 400mg. d^-1; the clinical effectivenesses and side-effects of thalidomide et al were evaluated and the serum level of VEGF and bone marrow MVD before the treatment were compared with 12 weeks after the treatment of thalidomideResults The total response rates were 63.64% and 65% in thalidomide alone group and in combination group respectively. The effective rates of refractory and relapsed MM were 62.5% and 60% in thalidomide alone group and in combination group respectively. In thalidomide alone group, the sVEGF levels were 326±33.67ng·L^-1 before the treatment of thalidomide, these were 124±20.26ng·L^-1 after 12 weeks respectively; the marrow MVD were 70.24±13.67 before the treatment of thalidomide, these were 46.13±16.56 after 12 weeks respectively; The differences between before and after treatment of thalidomide showed statistical significances respectively (p＜0.01, p＜0.01). In combination group, the sVEGF levels were 338±35.37ng·L^-1 before the treatment, these were135±24.36ng·L^-1 after 12 weeks respectively; the marrow MVD were 68.5±23.6before the treatment, these were 44±19.2 after 12 weeks respectively; The differences between before and after the treatment of thalidomide combined with chemotherapy showed statistical significances respectively (p＜0.01, p＜0.01). There were no differences between the two groups in the clinical effectivenesses and side-effects .Conclusion Either thalidomide alone in high dose or thalidomide in low dose combined with VAD chemotherapy was effective in the treatment of multiple myeloma, both groups could obviously decrease the levels of sVEGF and MVD. There were both diagnosis and therapeutic significances testing the level of sVEGF and bone marrow MVD of MM; There were better tolerations in combination group.