两种硼替佐米用药方案对多发性骨髓瘤患者的疗效观察

Comparison of the effects of two bortezomib medication regimens in patients with multiple myeloma

目的探讨两种硼替佐米用药方案对多发性骨髓瘤(MM)患者的疗效和药物不良反应的发生情况。方法选取2015年1月至2020年11月在本院血液科接受治疗的MM患者66例作为研究对象,采用随机数字表法分为A组和B组,每组33例。A组使用硼替佐米每周1次方案,B组使用硼替佐米每周2次方案。比较两组患者的血清M蛋白、骨髓浆细胞水平以及治疗第2、4个疗程的疗效及治疗过程中的不良反应。结果治疗前两组患者的血清M蛋白、骨髓浆细胞水平比较差异无统计学意义(P>0.05),治疗4个疗程后两组血清M蛋白、骨髓浆细胞均降低,两组比较差异无统计学意义(P>0.05)。治疗2个疗程时,B组患者的OR高于A组(30.30%vs.9.09%,P<0.05);治疗4个疗程时,两组总体反应(OR)比较差异无统计学意义(39.39%vs.27.27%,P>0.05)。A组的感染风险、周围神经病变风险、血液毒性反应低于B组(P<0.05),两组的消化道反应比较差异无统计学意义(P>0.05)。结论使用硼替佐米治疗MM患者每周2次方案比每周1次方案短期治疗效果更好,长期治疗效果相当,但每周1次方案比每周2次方案感染风险降低,周围神经病变风险减少。

Objective To explore the effects of two bortezomib medication regimens and the adverse reactions in patients with multiple myeloma(MM).Methods A total of 66 MM patients who were treated in hematology department of the hospital from January 2015 to November 2020 were selected as study subjects.They were divided into group A and group B by random number table method with 33 cases in each group.Group A was treated with bortezomib once a week,while group B was treated with bortezomib twice a week.The levels of serum M protein and bone marrow plasmocytes,curative effect after 2 and 4 courses of treatment,and adverse reactions during treatment were compared between the two groups.Results Before treatment,there were no significant differences in the levels of serum M protein or bone marrow plasmocytes between the two groups(P>0.05).After 4 courses of treatment,the levels of serum M protein and bone marrow plasmocytes were decreased in both groups,without statistically significant differences between the 2 groups(P>0.05).After 2 courses of treatment,the OR in group B was significantly higher than that in group A(30.30%vs 9.09%,P<0.05).After 4 courses of treatment,there were no significant difference in OR between group B and group A(39.39%vs 27.27%,P>0.05).The incidence rates of infection risk,peripheral neuropathy and hematological toxicity in group A were lower than those in group B(P<0.05),and there was no significant difference in gastrointestinal reactions between the two groups(P>0.05).Conclusion Compared with once a week,short-term curative effect of bortezomib twice a week is better for MM patients,but the long-term curative effect is comparable.However,the infection risk of once-a-week regimen is lower,and the risk of peripheral neuropathy is decreased.