硼替佐米的累计剂量对多发性骨髓瘤患者生存的影响

Effect of cumulative bortezomib dose on survival in multiple myeloma patients receiving bortezomib-containing regimens

目的:探讨硼替佐米的累计剂量对多发性骨髓瘤(MM)患者生存期的影响。方法:回顾172例MM患者的临床特点、实验室检查及治疗方法。以硼替佐米的中位累计剂量21mg/m^2为临界值,将172例MM患者根据中位累计剂量分为A组(<21mg/m^2,86例)和B组(≥21mg/m^2,86例),对2组患者的基本资料采用t检验(连续变量)和χ~2检验(分类变量)进行校检,并对2组采用Kaplan-Meier生存曲线进行生存分析,Log-rank检验作单因素分析。172例MM患者中,使用含硼替佐米化疗方案的患者有83例,以硼替佐米的累计剂量21mg/m^2为临界值,将患者分为C组(<21mg/m^2)和D组(≥21mg/m^2);使用含硼替佐米化疗方案联合其他化疗方案的患者有89例,以硼替佐米的累计剂量21mg/m^2为临界值,将患者分为E组(<21mg/m^2)和F组(≥21mg/m^2),对C、D两组以及E、F两组采用Kaplan-Meier生存曲线进行生存分析,Log-rank检验作单因素分析。结果:172例MM患者中,B组患者的中位生存期明显高于A组(73.53个月∶18.90个月,P<0.01);83例使用包含硼替佐米化疗方案的患者中,D组患者的中位生存期明显高于C组(60+个月∶17.67个月,P<0.01);89例使用包含硼替佐米化疗方案联合其他治疗的患者中,F组患者的中位生存期明显高于E组(57.13个月∶26.67个月,P<0.01)。与硼替佐米累计剂量低的患者相比,硼替佐米累计剂量较高的患者的严重不良反应发生率未增加。结论:提高硼替佐米的累计剂量能延长MM患者的生存期,而且未增加严重不良反应的发生率。

Objective：To explore the effect of cumulative bortezomib dose on survival in multiple myeloma（MM）patients receiving bortezomib-containing regimens.Method：A retrospective analysis was performed on the clinical characteristics,laboratory examination and therapeutic options of 172 cases of MM patients.The cumulative bortezomib dose 21mg/m2 was selected as the cut-off for defining the dose group to be compared for overall survival（OS）.The 172 cases of MM were divided into A（〈21mg/m2,n=86）and B（≥21mg/m2,n=86）groups.Eighty-three cases receiving bortezomib-containing regimens were divided into C（〈21mg/m2）and D（≥21mg/m2）groups.Eighty-nine cases receiving bortezomib-containing regimens and other therapies were divided into E（〈21mg/m2）and F（≥21mg/m2）groups.Characteristics of patients were well balanced between two groups（A and B）.Differences in baseline characteristics between groups were analyzed using the t-test for continuous variables and the χ2 test for categorical variables.Distributions were estimated using the Kaplan-Meier method.Differences in OS between groups were analyzed by Log-rank tests.Result：OS was significantly longer in B group than that in A group（73.53 vs.18.90 months,P〈0.01）;and was longer in D group than that in C group（60＋ vs.17.67 months,P〈0.01）;and was longer in F group than that in E group（57.13 vs.26.67 months,P〈0.01）.There was no increased incidence of serious adverse events in the higher compared lower cumulative bortezomib dose group.Conclusion：A higher cumulative dose of bortezomib may result in improved OS in MM patients.There is not an increased incidence of serious adverse events in the higher compared lower cumulative bortezomib dose group.