Frailty评分对枸橼酸伊沙佐米治疗多发性骨髓瘤不良反应的预测价值

目的 探讨Frailty评分对枸橼酸伊沙佐米治疗多发性骨髓瘤(multiple myeloma, MM)不良反应的预测价值。方法 选取MM患者72例，均予以枸橼酸伊沙佐米联合沙利度胺、地塞米松方案治疗，观察治疗效果及不良反应。并根据患者不良反应程度分为Ⅰ～Ⅱ级组和Ⅲ～Ⅳ级组。比较2组Frailty评分；采用Cox回归模型分析化疗相关Ⅲ～Ⅳ级不良反应的影响因素；采用ROC曲线模型分析Frailty评分对化疗相关Ⅲ～Ⅳ级不良反应的预测价值。结果 72例MM患者均实施枸橼酸伊沙佐米治疗，总有效率为80.55%;出现不良反应70例、以乏力占比最高，发生率为72.22%,其次为淋巴细胞降低25.00%、贫血18.06%,未出现任何不良反应2例。Ⅲ～Ⅳ级组Frailty评分高于Ⅰ～Ⅱ级组(P<0.05)。70例出现不良反应患者均随访12个月，其平均生存时间(22.30±2.28)个月。Cox回归分析结果显示，Frailty评分≥2分是MM患者发生Ⅲ～Ⅳ级不良反应的影响因素。ROC曲线分析显示，Frailty评分预测化疗相关Ⅲ～Ⅳ级不良反应AUC值为0.925(95%CI:0.816～1.00...

Predictive value of Frailty score for the adverse reactions of ixazomib citrate in the treatment of multiple myeloma

ObjectiveTo investigate the predictive value of Frailty score for adverse reactions of ixazomib citrate in the treatment of multiple myeloma(MM).MethodsA total of 72 patients with MM were selected and treated with ixazomib citrate combined with thalidomide and dexamethasone (TD) regimen. The therapeutic effect and adverse reactions were observed. According to the degree of adverse reactions of patients, they were divided into grade Ⅰ-Ⅱ group and grade Ⅲ-Ⅳ group.The Frailty score was compared between two groups. Cox regression model was used to analyze the influencing factors of chemotherapy-related grade Ⅲ-Ⅳ adverse reactions. Receiver operating characteristic (ROC) curve model was used to analyze the predictive value of Frailty score for chemotherapy-related grade Ⅲ-Ⅳ adverse reactions.ResultsAll 72 MM patients were treated with ixazomib citrate, with a total effective rate of 80.55%; adverse reactions occurred in 70 cases, and fatigue accounted for the highest proportion, with an incidence rate of 72.22%, followed by lymphocyte reduction of 25.00% and anemia of 18.06%, and no adverse reactions occurred in 2 cases. The Frailty score of grade Ⅲ-Ⅳ group was higher than that of grade Ⅰ-Ⅱ group(P＜0.05). The 70 patients with adverse reactions were followed up for 12 months, and their average survival time was (22.30±2.28) months. Cox regression analysis showed that Frailty score ≥ 2 was the influencing factor of grade Ⅲ-Ⅳ adverse reactions in MM patients.ROC curve analysis showed that the Frailty score predicted chemotherapy-related grade Ⅲ-Ⅳ adverse reactions with an AUC value of 0.925(95%CI: 0.816-1.000, P＜0.001), a sensitivity of 88.90% and a specificity of 100.00%.ConclusionCommon adverse reactions during the treatment of MM patients with ixazomib citrate are fatigue, anemia, and thrombocytopenia. During treatment, the Frailty scoring system is used to evaluate adverse reactions, which is helpful for timely detection of those with high risk of adverse reactions and provides guidance for the adjustment of treatment plans.