硼替佐米联合地塞米松治疗多发性骨髓瘤的临床研究

目的观察硼替佐米联合地塞米松治疗多发性骨髓瘤(MM)的临床疗效及安全性。方法 12例初治MM患者及6例难治复发患者均采用硼替佐米联合地塞米松化疗(硼替唑米1.3mg/m~2,第1、4、8、11天快速静脉注射;地塞米松20～40mg,第1～4、8～11天静脉滴注或口服;3周为1个疗程)1～6个疗程,根据EBMT疗效标准评价疗效,按NCI-CTCAE标准评价不良反应。结果平均随访6个月(2～11个月),12例初治患者中3例完全缓解(CR),6例部分缓解(PR),2例轻微反应(MR),1例无变化(NC)。6例难治复发患者中2例CR,2例PR,1例NR,1例死亡。总反应率(ORR=CR+PR+MR)83.33%,总有效率(CR+PR)72.22%。主要不良反应为乏力、血小板减少、白细胞减少、腹泻、周围神经病变和阵发性房颤,经对症处理后基本缓解。结论硼替佐米联合地塞米松治疗初发或难治性多发性骨髓瘤是一种有效的新方法,不良反应较轻,患者可耐受。

Bortezomib in Combination with Dexamethasone for Multiple Myeloma: A Clinical Study

Objective To evaluate the efficacy and safety of bortezomib combined with dexamethasone in the treatment of multiple myeloma （MM）. Methods Twelve patients newly diagnosed as MM and 6 patients with relapsed or refractory MM were treated with bortezomib combined with dexamethasone（bortezomib 1.3mg/m^2, d1, 4,8,11, dexamethasone 20-40mg, dl-4,8-11 ） in 3 weeks as a course of treatment. The patients received lto 6 courses of treatment. Response was evaluated according to the EBMT criteria and adverse reactions were graded according to the NCI-CTCAE（version 3.0）. Results The 6-month（2-11months） median follow-up showed out of the 12 patients newly diagnosed MM,two achieved complete response（CR）, six partial response（PR）,three minor response（MR）and no change for one. The 6 patients with refractory/relapsed myeloma achieved CR （ 2/6 ）, PR （ 2/6 ）, NR （ 1/6 ）and one died. Clinical response rate was 83.33 % ）. The overall response rate （ CR＋PR ） was 72.22%. The most adverse events observed were fatigue （ 11/18,61.11% ）, thrombocytopenia （ 5/18,27.67 % ）, neutropenia （ 2/18, 11.11% ）, diarrhea（ 3/18,16.67% ）, peripheral neuropathy（3/18,16.67%）and paroxysmal atrial fibrillation（ 1/18,5.56% ）. Conclusion Bortezomib combined with dexamethasone is a new and effective treatment for MM patlents,with mild adverse reactions.