硼替佐米为主的化疗方案治疗40例多发性骨髓瘤疗效分析

本研究观察硼替佐米为主方案治疗多发性骨髓瘤的疗效及不良反应。16例初治、11例复发难治性患者采用硼替佐米联合地塞米松与沙利度胺（VDT方案）化疗,7例初治、4例复发难治性患者采用VD方案化疗,2例初治患者采用硼替佐米联合美法仑与沙利度胺（VPT方案）化疗,28天或35天为1个疗程,所有患者均接受2-8疗程化疗,观察其疗效及不良反应。结果显示：中位随访时间为13个月,总有效率为72.5%,其中16例完全缓解（CR）,13例部分缓解（PR）。主要不良反应包括胃肠道症状、周围神经病变、血小板减少、呼吸道感染、带状疱疹及尿潴留等,经对症治疗和减低剂量后均缓解。结论：硼替佐米治疗初治或复发难治性多发性骨髓瘤的疗效确切,患者对其不良反应一般可以耐受。

Therapeutic Efficacy of Bortezomib-based Chemotherapy on 40 Patients with Multiple Myeloma

This study was aimed to investigate the therapeutic efficacy and adverse events of bortezomib-based chemotherapy for 40 patients with multiple myeloma. 16 newly diagnosed patients and 11 patients with refractory/relapse myeloma were treated with bortezomib,dexamethasone and thalidomide; 7 newly diagnosed patients and 4 patients with refractory/relapse myeloma were treated with bortezomib and dexamethasone; 2 newly diagnosed patients were treated with bortezomib,melphalan and thalidomide. Cycles were repeated every 28 or 35 days,all the patients were treated for 2 to 8 cycles. The therapeutic efficacy and adverse events were evaluated according to International Myeloma Working Group Uniform Response Criteria. The results indicated that the median follow-up duration was 13 months,the total response rate was 72.5%,among which 16 patients achieved complete response （CR）,13 achieved partial response （PR）. The main side effects included gastrointestinal symptoms,peripheral neuropathy,thrombocytopenia,respiratory infection,herpes zoster and urinary retention and so on. The adverse events were ameliorated by treatment and decrease of the bortezomib dose. It is concluded that bortezomib-based chemotherapy is effective in the treatment of either newly diagnosed or refractory/relapse MM patients and the adverse events are tolerable and manageable for patients.