硼替佐米治疗多发性骨髓瘤患者发生带状疱疹危险因素分析

Analysis of Risk Factors of Herpes Zoster in Patients with Multiple Myeloma Treated with Bortezomib

目的:探讨并分析多发性骨髓瘤(MM)患者在硼替佐米化疗期间发生带状疱疹的危险因素。方法:收集2015年1月到2019年1月于甘肃省人民医院接受以硼替佐米为主的化疗方案治疗的85例MM患者的临床资料,依据是否发生带状疱疹分为病例组和对照组。对其临床特点、治疗和转归及发生带状疱疹的危险因素进行回顾性分析。结果:85例使用硼替佐米化疗的MM患者中,20例发生了带状疱疹,发生率约为23.5%。单因素分析显示,年龄≥65岁、治疗前淋巴细胞减少、治疗前中性粒细胞减少、ECOG评分≥2、使用环磷酰胺、未给予预防性抗病毒治疗与带状疱疹发生相关(P<0.05)。多因素logistic回归分析显示,治疗前淋巴细胞减少、环磷酰胺的使用、未给予预防性抗病毒治疗是发生带状疱疹独立的危险因素(P<0.05)。结论:MM患者带状疱疹发生率高,治疗前淋巴细胞减少、环磷酰胺的使用、未给予预防性抗病毒治疗是发生带状疱疹重要的危险因素,临床医生需引起重视。

Objective:To explore and analyze the risk factors of herpes zoster in patients with multiple myeloma(MM)during the chemotherapy with bortezomib.Methods:Clinical data of 85 MM patients treated with bontizomib from January 2015 to January 2019 were selected and divided into case group and control group accroding to the occurred of herpes zoster.The clinical characteristic,treatment outcome and related factor of herpes zoster were retrospective analyzed.Results:Twenty of the 85 patients with MM treated with bortezomib developed herpes zoster occurred(23.5%).Single-factor analysis showed that age≥65 years,lymphocytopenia occurred before treatment,neutropenia occurred before treatment,ECOG score≥2,application of cyclophosphamide,absence of preventive antiviral therapy were associated with the genesis of herpes zoster(P<0.05).Multivariate logistic regression analysis showed that lymphocytopenia occurred before treatment,the application of cyclophosphamide and the absence of preventive antiviral therapy were the independent risk factors for herpes zoster(P<0.05).Conclusion:The incidence of herpes zoster is high in the multiple myeloma patients treated with bortezomib.Lymphocytopenia occurred before treatment,the application of cyclophosphamide,and the absence of prophylactic antiviral therapy are the important risk factors for herpes zoster,for which the clinicians should attach great importance.