多发性骨髓瘤患者应用硼替佐米再治疗的疗效分析

Efficacy analysis of retreatment with bortezomib for relapsed multiple myeloma

目的探讨多发性骨髓瘤(MM)患者应用硼替佐米再治疗的安全性及有效性。方法选取106例MM患者,所有患者均于第一次应用硼替佐米时达到部分缓解及其以上疗效,并再次应用硼替佐米治疗。评价硼替佐米再治疗的疗效和不良反应发生情况。结果 106例MM患者均为复发难治性患者,均接受了含硼替佐米方案的再治疗,总有效率为65.09%,中位无疾病进展生存时间为7.8个月。再治疗时,106例MM患者发生的不良反应包括疲乏、血小板减少、腹泻、便秘、周围神经病变、带状疱疹和肺炎,其中,4例患者因发生3级周围神经病变而终止治疗;3例患者于再次接受含硼替佐米方案治疗时死亡,其中,2例患者死于疾病进展,1例患者死于肺部感染。结论初次应用硼替佐米取得较好疗效的MM患者再次应用硼替佐米治疗时仍可取得良好的缓解效果,患者均能良好耐受。

Objective To evaluate the efficacy and safety of retreatment with a bortezomib-based therapy in patients with relapsed multiple myeloma(MM).Method The clinical records of 106 MM patients were included in the analysis.All the individuals had achieved partial and even better response after initial bortezomib therapy,and were then retreated with bortezomib,the efficacy and incidence of adverse reactions of the subsequent therapy were assessed.Result All the 106 MM cases were with relapsed and refractory diseases,and had underwent retreatment with bortezomib,achieving an overall response rate of 65.09%,with a median progression-free survival of 7.8 months.During retreatment,adverse reactions were noted in 106 cases of MM included fatigue,thrombocytopenia,diarrhea,constipation,peripheral neuropathy,herpes zoster and pneumonia,and 4 cases discontinued the initial treatment due to grade 3 peripheral neuropathy;3 cases died during retreatment of bortezomib-based therapy,among them,2 died from disease progression,and another died of pulmonary infections.Conclusion Retreatment with bortezomib-based regimen results in acceptable remission in patients who had good response to initial bortezomib-based therapy,and the treatment could be tolerated in these patients.