硼替佐米联合地塞米松治疗多发性骨髓瘤20例临床疗效分析

目的 分析硼替佐米联合地塞米松（PD）化疗方案治疗多发性骨髓瘤（multiple myeloma,MM）患者的疗效和不良反应.方法 回顾性分析20例（初治12例,复发8例）采用PD基础方案化疗（硼替佐米1.0～1.3mg/m2 iv,d1、d4、d8、d11,地塞米松10 ～20 mg iv,d1 ～2,d4～5,d8～9,d11～12,21天为1个疗程,2～3个疗程）患者的临床资料,根据EBMT标准观察疗效,根据NCI-CTCAE标准判断不良反应.结果 PD组12例初治患者6例CR （50％）,5例PR （41.6％）,1例MR（8.4％）,ORR为91.6％;8例复发患者,3例CR （37.5％）,3例PR （37.5％）,1例MR （12.5％）,1例PD （12.5％）,ORR为75％,PD组总的ORR为85％.主要不良反应有胃肠道症状（8例）、Ⅰ～Ⅱ级周围神经炎（6例）、带状疱疹（3例）、血小板减少NCICTCAE 2级（3例）、低血压（1例）.结论 硼替佐米联合地塞米松治疗MM起效快,完全缓解率高,不良反应低.

Clinical efficacy of the bortezomib combined with dexamethasone in 20 multiple myeloma patients

Objective To investigate the efficacy and the adverse effects of bortezomib combined with dexamethasone （PD） in the treatment of multiple myeloma （MM）. Method Retrospective analysis was performed on the clinical data of 20 patients with MM （ 12 newly diagnosed MM and 8 relapsed or refractory MM）, who were treated with PD （ bortezomib 1.0 - 1.3 rag/m： iv, and dexamethasone 20 mg iv, dl-2, d4-5, d8-9, dll- 12）, with 21 days as one cycle. Response and adverse effects were evaluated as per EBMT NCICTCAE （verslon 3.0）, respectively. Result In PD group the clinical re- sponse of 12 newly diagnosed patients was 91.6%, including CR 6 （50%）, PR 5 （41.6%）, MR 1 （8.4%）. In 8 patients with relapsed MM, ORR is 75% CR 3 （37. 5% ）, PR 3 （37. 5% ）, MR 1 （ 12. 5% ）, PD 1 （ 12. 5% ） 1, so the total ORR is 85% in PD group. The most common adverse events were gastrointestinal symptoms （8/20） , I- II grade peripheral neu- ropathy （6/20）, herpes zoster （3/20）, NCICTCAE grade 2 thrombocytopenia （3/20） and hypotension （1/20）. Conclu- sion The PD regimen works fast in the treatment of multiple myeloma, with high ORR and minor adverse events.