硼替佐米致肺损伤33例文献分析

Analysis of 33 patients with lung injury induced by bortezomib based on literature review

目的探讨硼替佐米致肺损伤的发生规律及特点,为安全合理用药提供参考。方法以"硼替佐米"和"肺损伤"与"bortezomib"和"lung injury/pulmonary complications"为检索词,检索2003年5月—2016年9月CNKI、VIP、Wanfang及Pub Med数据库收载的硼替佐米致肺损伤病例个案报道,并进行分析。结果共筛选出有效个案报道23篇,计33例患者,男性21例,女性12例,年龄65岁及以上患者16例(48%)。女性患者中死亡8例(67%);接受过自体外周血干细胞移植(auto-PBSCT)治疗史7例,4例(57%)死亡;未合用地塞米松化疗11例,9例(82%)死亡。应用硼替佐米后14 d内出现肺损伤16例(48%),其中死亡10例(63%)。32例停药并给予激素等治疗,死亡15例。结论硼替佐米应用早期即应密切防范肺损伤的发生,尤其是女性、有auto-PBSCT治疗史及未联合地塞米松化疗的患者。

AIM To analyze the general patterns and characteristics of lung injury induced by bortezomib and provide reference for clinical medication therapy. METHODS ＂Bortezomib＂ and ＂lung injury/pulmonary complications＂ were selected as the keywords. The case reports of lung injury induced by bortezomib were collected and analyzed statistically from CNKI, VIP, Wanfang and PubMed from May 2003 to September 2016. RESULTS A total of 23 reports involving 33 patients （21 males and 12 females） were included, and 16 patients （48%） aged 65 years or over. The number of deaths in 12 female patients, 7 patients with history of antologous peripheral blood stem cell transplantation （auto-PBSCT） therapy and 11 patients with dexamethasone combination chemotherapy was 8 （67%）, 4 （57%） and 9 （82%）. Sixteen patients with lung injury caused by bortezomib attacked within 14 days （48%）, and 10 patients （63%） died. Thirty- two patients stopped bortezomib therapy and received glucocorticoids treatment after pulmonary complications appearance, but 15 patients died. CONCLUSION Lung injury should be closely guarded early in the application of bortezomib, especially in female and patients with history of auto-PBSCT therapy or not receiving dexamethasone combination chemotherapy.