硼替佐米节律性化疗对老年多发性骨髓瘤的疗效研究

Cinical Study of Bortezomib Metronomic Chemotherapy for Elderly Multiple Myeloma(MM) Patients

目的探讨硼替佐米节律性化疗对老年多发性骨髓瘤(MM)的疗效研究。方法对8例初治伴严重并发症老年MM患者均给予节律性化疗:硼替佐米1 mg/m2·qw+地塞米松10 mg/qw,4周为1个疗程(VD),休息1个月,重复上述方案,共化疗6个疗程。结果 8例患者中有效率为100%。1～2个疗程后完全缓解6例,完全缓解率为75%,另2例患者化疗1～2个疗程后获得部分缓解,但分别于化疗后6个月～1年死于感染和出血。结论硼替佐米节律性化疗对伴有严重并发症的MM患者,疗效显著,且患者耐受性好,不良反应少。节律性化疗在MM中的作用机制与抑制新生血管的生成是否有关,有待进一步研究探讨。

Objective To discuss the clinical effects of bortezomib metronomic chemotherapy for elderly multiple myeloma（MM） patients. Methods 8 elderly MM patients with serious complications were treated with metronomic chemotherapy： Bortezomib 1 mg/m2 · qw ＋ dexamethasone 10 mg/qw for 4 weeks （VD） as 1 cycle, rest for 1 month and repeat the above scheme for 6 cycles. Results The response rate of 8 patients was 100%. 6 patients obtained complete remission after 1 - 2 cycles, and complete remission rate was 75 % , the other 2 patients obtained partial remission afterl -2 cycles, and died after 6 - 12 months because of infection and bleeding. Conclusion Bortezomib metronomic chemotherapy for elderly MM patients with serious complications is effective, well-tolerated and with less adverse reactions. The mechanism of metronomic chemotherapy in MM and its relationship with inhibition angiogenesis needs further study.