Efficacy and mechanism of thalidomide combined with chemotherapy in the treatment of patients with acute leukemia
1.Department of Hematology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027; 2.Department of Laboratory, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027
ZHU Baoling1,HE Muqing1,LIN Xiaoji1, et al. Efficacy and mechanism of thalidomide combined with chemotherapy in the treatment of patients with acute leukemia[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(9): 649-.
Abstract：Objective: To observe the clinical effect of thalidomide combined with chemotherapy in the treatment of acute leukemia patients and its’ influence on plasma concentration of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), bone marrow microvessel density (MVD) level. Methods: Forty cases of acute leukemia patients, randomly divided into trial group and conventional group with 20 cases in each group. The other 20 healthy peoples were selected underwent physical examination as control group. The trial group and conventional group were treated with conventional chemotherapy, in the trial group additional thalidomide 100 mg/day were taken orally. Before treatment and 8 weeks after treatment, plasma were collected for the detection of VEGF, bFGF and bone marrow tissue for MVD. Results: The effective rate of the trial group and the conventional group respectively were 85% and 70%, the effective rate of the trial group was higher than that of the conventional group, but the difference wasn’t statistically significant (P>0.05). Before treatment,the level of VEGF, bFGF in plasma of the trial group and the conventional group was significantly higher than that in the healthy group (P<0.05), and there’s no significant difference between the trial group and the conventional group. After treatment, the levels of VEGF and bFGF of the trial group and the conventional group were still higher than those of the healthy group (P<0.05), but there’s no significant differences in bFGF levels before and after treatment (P>0.05), the levels of VEGF in the trial group was lower than those in the conventional group after treatment (P<0.05). Linear regression analysis indicated that the VEGF of plasma and the MVD level was negatively correlated with clinical effects (β=-0.065, t=-2.215, P<0.05; β=-0.078, t=-2.451, P<0.05), and there’s no correlation between bFGF and clinical effects. Conclusion: Thalidomide combined with chemotherapy can improve the remission rate of acute leukemia patients, the mechanism of anti-leukemia may contribute to inhibiting the plasma levels of VEGF and decreasing MVD, and antiangiogenic activity.
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