硼替佐米为主方案治疗初发多发性骨髓瘤临床研究

Clinical study of bortezomib-based chemotherapy in treatment of newly diagnosed multiple myeloma

目的观察以硼替佐米为主方案治疗初发多发性骨髓瘤的临床疗效及不良反应。方法回顾性分析本院15例以硼替佐米为主方案治疗初发多发性骨髓瘤的临床资料,疗效评定采用中国多发性骨髓瘤诊治指南标准,不良反应标准参照美国国立癌症研究所的常规毒性判定标准3.0版NCI-CTCAE。结果 15例中位随访16月,完全缓解/接近完全缓解(CR/nCR)8例,非常好的部分缓解(VGPR)2例,部分缓解(PR)2例,微小缓解(MR)1例,无变化(NC)1例,疾病进展(PD)1例,有效率80.0%(12/15)。15例患者中主要不良反应有胃肠道症状(60.0%)、周围神经病变(66.7%)、白细胞减少(46.7%)、血小板减少(55.6%)、感染(23.3%),少见不良反应有心律失常、心功能不全。结论硼替佐米为多发性骨髓瘤患者的治疗提供了有效的途径,该药起效快,缓解率高,安全性好。

Objective To observe the clinical efficacy and adverse effects of bortezomib in treatment of newly diagnosed multiple myeloma（MM）.Methods Fifteen MM patients underwent bortezomib-based chemotherapy treatment in Zhongshan Hospital,Sun Yat-sen University.Initial efficacy was evaluated according to the criteria of the CHINA Group for Multiple Myeloma.Toxic reactions were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events（NCI-CTCAE,version 3.0）.Results The median follow-up time was 16 months.After receiving different treatment courses,8 cases obtained complete remission,2 nearly complete remission,2 partial remission,1 minimal remission,1 no change,1 progressive disease.Clinical response rate of 15 patients was 80.0%.The most common adverse events were gastrointestinal symptoms（60.0%）,followed by peripheral neuropathy（66.7%）,leucocytopenia（46.7%）,thrombocytopenia（55.6%）,infection（23.3%）.The fewer adverse events were arrhythmia and heart failure.Conclusion Bortezomib-based chemotherapy is accurately effective in the treatment of newly diagnosed MM with fast-acting,higher remission rate,and safe.