硼替佐米治疗复发难治性多发性骨髓瘤43例

目的 观察硼替佐米联合地塞米松、甲泼尼龙或其他化疗药物治疗复发难治多发性骨髓瘤(MM)的临床疗效与不良反应.方法 43例复发难治MM患者.男34例,女9例,年龄36～72岁,平均年龄58.13岁.其中31例接受硼替佐米联合甲泼尼龙或地塞米松(VMP或VD)方案治疗,12例接受硼替佐米联合环磷酰胺、泼尼松、沙利度胺(VCPT)治疗或联合环磷酰胺、地塞米松、顺铂、依托泊苷(VDECD)治疗,每个患者至少接受2～8个疗程的治疗.采用Biadè标准评价疗效,按照美国国立癌症研究所常规毒性判断标准(NCI CTCAE3.0)判断不良反应.结果中位随访9个月,复发难治患者43例,完全缓解(CR)5例(11.6%),接近CR(nCR)11例(25.6%),部分缓解(PR)15例(34.9%),轻微反应(MR)5例(11.6%).总有效率(CR+nCR+PR+MR)83.7%.主要不良反应有乏力、胃肠道症状、周围神经病变、不同程度的血小板减少、皮疹及带状疱疹等,经过对症治疗以及调整剂量后均能改善.结论 硼替佐米联合其他药物治疗复发难治MM是一种安全可靠、有较好治疗前景的方法 .

Effect of treatment by bortezomib with other drugs for the refractory multiple myeloma

To investigate the efficacy and safety of bortezomib-dexamethasone,bortezomibmethylprednisolone combined with other drugs in the treatment of patients with multiple myeloma(MM).43 patients(male/female:32/9,mean age:58.13 years)with refractory or relapsed myeioma were treated.Other patients were administered bortezomib in combination with methylprednisolone or dexamethasone,or CPT and the common Toxicity Criteria,version 3.0(NCI,USA).The median follow-up fmm the start of bortezomib treatment was 9 months.Out of 43 refractory or relapsed patients,5 achieved CR,11 nearly CR,15 PR and 5 MR resulted in an ORR of 83.7%.The main toxicities were fatigue.gastrointestinal disorders.peripheral neuropathy,thrombocytopenia,herpes zoster,skin rash.All adverse effects were manageable with routine treatment.In short,Bortezomib plus other drugs is an very effective regiment,in which the side effects are predictable and manageable.