硼替佐米联合地塞米松治疗多发性骨髓瘤的临床观察

Clinnical Observation of Bortezomib Plus Dexamethasone in the Treatment of Patients with Multiple Myeloma

目的探讨硼替佐米联合地塞米松治疗多发性骨髓瘤(MM)的疗效及安全性。方法 11例MM患者接受硼替佐米加地塞米松(VD方案)治疗,在每一疗程的第1、4、8、11天快速静脉注射硼替佐米1.3mg/m2,第1～4、8～11天静脉滴注地塞米松20mg/m2,每3周为一疗程,共6个疗程。结果除1例患者在2疗程治疗后因疾病进展而终止治疗外,其余患者均完成6个疗程VD方案治疗。总有效率为90.9%(10/11例);其中,完全缓解(CR)率为27.3%(3/11例),接近CR(nCR)率为27.3%(3/11例),部分缓解(PR)率为36.4%(4/11例)。最常见的≧2级不良反应是周围神经病变36.4%(4/11例),便秘及肌肉疼痛均为27.3%(3/11例),和乏力18.2%(2/11例)。结论硼替佐米加地塞米松为一安全﹑有效的MM诱导治疗方案。

【Objective】 To explore the clinical outcome of bortezomib plus dexamethasone in the treatmeant of adult patients with Multiple myeloma（MM）.【Methods】 11 Patients with MM were assigned to receive bortezomib 1.3 mg/m2 intravenously on days 1,4,8,11,and dexamethasone 20mg/m2 intravenously on days 1～4,8～11,on a 21 day cycle for six cycles.【Results】 Except one patient discontinued therapy after two cycles of bortezomib plus dexamethasone treatment due to progressive disease,10 patients completed the six cycles of treatment.The overall response rate was 90.9%,of whom 27.3% achieved complete response（CR）,27.3% near CR,and 36.4% partial response.The most common adverse events ≥grade 2 included sensory neuropathy（31%）,constipation（27.3%）,myalgia（27.3%） and fatigue（18.2%）.The adverse events improved or resolved after modification of the bortezomib dose and symptomatic treatment.【Conclusion】 Bortezomib in combination with dexamethasone is an effective induction therapy and manageable toxicities in patients with MM.