硼替佐米联合化疗治疗10例多发性骨髓瘤

目的:观察硼替佐米联合化疗药物治疗初治、复发难治多发性骨髓瘤(MM)的疗效及安全性。方法:5例初治MM患者在每一疗程的第1、4、8、11天静脉注射硼替佐米0.7～1.3mg/m2,每3周为一疗程;每2个疗程(6周)的第1～4天,口服美法仑9mg/(m2·d)和泼尼松60mg/(m2·d);每例患者至少接受2～10个疗程。5例复发难治患者,在每3周1个疗程,第1、8天分别静脉注射硼替佐米3.5mg,或第1、4、8、11天1.0～1.3mg/m2。每次用硼替佐米前静脉注射地塞米松40mg;每例患者至少接受1～6个疗程。采用Blade标准评价疗效,按照美国国立癌症研究所(NCI)(第3版)判断不良反应。结果:中位随访8个月,5例初治患者中2例完全缓解(CR),1例接近完全缓解(nCR),1例部分缓解(PR),1例轻微反应(MR)。5例复发难治患者中,2例nCR,2例MR,1例无改变(NC)。主要不良反应包括胃肠道症状、不同程度的血小板减少、周围神经症状和乏力等。经对症治疗及调整用药剂量后均能改善。结论:硼替佐米对于初治或复发难治的MM患者,是一种可以耐受的、疗效确切的新的治疗选择。

Efficacy evaluation of bortezomib plus chemotherapy in patients with multiple myeloma

Objective To evaluate the efficacy and safety of bortezomib plus chemotherapy in treating multiple myeloma(MM) patients.Methods Five MM patients without previous treatment received bortezomib 0.7-1.3 mg/m2 intraveneously on days 1,4,8,and 11 every 3 weeks.Melphalan(9 mg/m2) and prednisone(60 mg/m2) were administrated once daily on days 1-4 every 6 weeks.The regimen had repeated for 2-10 cycles.Five patients with relapse or refractory MM received bortezomib 1.0-1.3 mg/m2 in combination with dexamethasone 40 mg on days 1 ,4,8,and 11 every 3 weeks.The regimen had repeated for 1-6 cycles.The European Group for Blood and Marrow Transplant(EMBT) response criteria,as described by Blade,were used to assess the response.Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events(NCICTCAE,version 3.0).Rusults The median follow-up duration from the beginning of bortezomib treatment was 8 months.Among 5 newly diagnosed MM patients,2 were complete response(CR),1 near complete response(nCR),1 partial response(PR) and 1 minimal response(MR).Among 5 refractory MM patients,2 had confirmed nCR,2 MR,and 1 no change(NC).The most common adverse events were gastrointestinal symptoms,thrombocytopenia,peripheral neuropathy and fatigue.All the adverse events were manageable with symptomatic therapy and(or) dose modification.Conclusions Bortezomib plus chemotherapy was well tolerated and effective in treating either newly-diagnosed or refractory MM patients.