硼替佐米周用药化疗方案治疗初诊多发性骨髓瘤效果及安全性

Effect of weekly administration of bortezomib in chemotherapy regimen in treating newly diagnosed multiple myeloma

目的探讨硼替佐米周用药化疗方案治疗初诊多发性骨髓瘤（MM）的效果及安全性。方法回顾性选取2012年11月至2014年8月在北京大学血液病研究所入组接受治疗的初诊MM患者40例，所有患者均采用PAD方案（硼替佐米＋表阿霉素＋地塞米松）治疗，35d为1个疗程，硼替佐米周用药方案：1．3mg／m2，第1、8、15、22天静脉注射；表阿霉素：15mg／m2，第1～4天静脉滴注；地塞米松：40mg/d，第1-4天静脉注射。评估患者的治疗结果及不良反应。结果所有患者治疗4-12个疗程，中位疗程数为8个疗程。取得最好疗效的疗程数为1—9个，9个疗程后总有效率87．5％（35／40），其中18例（45．0％）完全缓解，1例（2．5％）接近完全缓解，11例（27．5％）非常好的部分缓解，5例（12．5％）部分缓解，3例（7．5％）治疗无效，2例（5．0％）已取得部分缓解患者发生疾病进展。所有患者未发生3级以上不良反应。结论硼替佐米周用药的PAD方案在初诊MM治疗中疗效明显，不良反应少。

Objective To explore the efficacy and safety of weekly administration of bortezomib in PAD chemotherapy regimen in treating newly diagnosed multiple myeloma （MM）. Methods Totally 40 patients with newly diagnosed symptomatic MM from November 2012 to August 2014 were enrolled and received PAD regimen （bortezomib ＋ pharmorubicin ＋ dexamethasone）, 35 days as one therapy course. Regimen of bortezomib： 1.3 mg/m2, intravenous injection on the 1st, 8th, 15th and 22th day; regimen of pharmorubiein： 15 mg/m2 , intravenous drip on the 1 st to the 4th day; dexamethasone： 40 mg/d, intravenous injection on the 1 st to the 4th day. The effect and toxicity were evaluated. Results The patients received 4-12 therapy courses, with median courses of 8. After 1-9 courses, the maximal effect was acquired; the overal response achieved 87. 5% （35/40） after 9 courses, including 18 cases （45.0%） of complete response, 1 cases （2.5%） of near complete response, 11 cases （27.5%） of very good partial response, and 3 cases （7.5%） of partial response; 3 cases （7.5%） were ineffective and 2 cases （ 5.0% ） of partial response had progress. Grade 3 or worse adverse events was not observed. Conclusion PAD chemotherapy regimen with weekly administration of bortezomib has good effect and low toxicity in treating newly diagnosed MM.