硼替佐米联合地塞米松治疗16例复发、难治性多发性骨髓瘤患者

目的 观察硼替佐米联合地塞米松治疗复发、难治性多发性骨髓瘤（MM）患者的疗效和不良反应。方法16例复发、难治性MM患者，男性9例，女性7例，平均年龄57．5（40～77）岁。在为期3周的疗程内给予硼替佐米3．5mg静脉注射，第1，8天或1．3mg／m^2，第1，4，8和11天。每次使用硼替佐米之前给予地塞米松30～40mg静脉注射。每例患者接受1～4个疗程的治疗。采用EBMT标准观察疗效，并按NCICTCAE（第3版）标准判断不良反应。结果 中位随访6个月，14例（87．5％）患者对治疗有效，其中7例患者接近完全缓解，5例部分缓解，2例轻微反应，2例无变化。最常见的不良反应为胃肠道症状，存16例患者中，12例患者有不同程度的恶心或呕吐，3例出现便秘，3例发生严重腹泻，有8例血小板减少，另有3例乏力等，经对症治疗后均获缓解。结论 硼替佐米联合地塞米松是一种对复发、难治性MM的新的治疗选择，不良反应少。

Bortezomib in combination with dexamethasone for the treatment of relapsed or refractory multiple myeloma

Objective To investigate the efficacy and toxicity of bortezomib in combination with dex- amethasone for the treatment of patients with relapsed or refractory multiple myeloma(MM).Methods Six- teen patients (9 males,7 females,mean age 57.5 yrs) with refractory or relapsed MM were treated with bort- ezomib (1.3 mg/m~2)by intravenous bolus twice a week for 2 weeks,or 3.5 mg once a week in a 21-day cy- cle,followed by an intravenous injection of dexamethasone 30-40 rag.The patients had received one to four courses at least.Response to bortezomib was evaluated according to the criteria of the European Croup for Blood and Marrow Transplantation (EBMT) before initiation of each bortezomib chemotherapy course.Ad- verse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0. Results The median follow-up duration from the begining of bortezomib treatment was 6 months.Clinical re- sponse was observed in 14 patients (87.5%) ,including near complete response in 6,partial response in 5, minimal response in 3 and no response in 2.The most common adverse events were gastrointestinal symptoms (nausea and vomiting in 12,constipation in 3,severe diarrhea in 3 patients) ,thrombocytopenia (8 patients) and fatigue(3 patients).The adverse events were subsided on routine supportive care.Conclusions Borte- zomib in combination with dexamethasone is an effective therapy with a high response rate and manageable toxicities for patients with relapsed or refractory myeloma.