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目的探讨沙利度胺联合VAD方案治疗老年多发性骨髓瘤（mulitiplemyeloma，MM）的临床疗效及用药安全性。方法将76例老年MM患者采用数字表法随机分为2组，对照组（n=38）单用VAD方案，观察组（n=38）采取沙利度胺联合VAD方案治疗，比较2组临床疗效及不良反应发生情况。结果观察组总有效率为84.21%，显著高于对照组的55.26%（P<0.05）；观察组治疗后M蛋白、骨髓瘤细胞和β2-微球蛋白分别为（20.77±4.15）×10-2μg/mL、（12.84±2.85）×10-2μg/mL和（2.48±0.53）μg/mL，均显著低于治疗前和对照组（P<0.05）；血红蛋白为（108.83±5.81）g/L，较治疗前和对照组明显升高，差异有统计学意义（P<0.05）；2组治疗后不良反应主要有恶心、呕吐、嗜睡、便秘、感染及皮疹等，且各不良反应发生率比较均无显著性差异。结论沙利度胺联合VAD方案治疗老年多发性骨髓瘤疗效显著优于单用VAD方案，且不良反应少，患者耐受性好。“,”Objective To investigate the efifcacy of thalidomide combined with VAD in treatment of elderly multiple myeloma(MM). Methods 76 cases of elderly MM were randomly divided into two groups, control group (n=38) were treated with VAD alone while the observation group (n=38) were treated with thalidomide and VAD. Clinical efifcacy and adverse reactions in two groups were compared. Results The total effective rate in observation group was 84.21%, which was signiifcantly higher than 55.26%in control group (P<0.05). After treatment, the M protein, myeloma cells andβ2-microglobulin in observation group were (20.77±4.15)×10-2μg/mL, (12.84±2.85)×10-2μg/mL and (2.48±0.53)μg/mL, which were signiifcantly lower than before treatment and control group(P<0.05). Hemoglobin in observation group was (108.83±5.81) g/L, which was signiifcantly higher than before treatment and control group(P<0.05). The adverse reactions were nausea, vomiting, drowsiness, constipation, infection and rash and so on in two groups after treatment, and there was no signiifcant difference between two groups. Conclusion Thalidomide combined with VAD regimen has a better effect in treatment of elderly multiple myeloma than single VAD, has less adverse reactions and well tolerated.