伊沙佐米治疗多发性骨髓瘤的疗效及其在SDF1/CXCR4轴机制的研究

Efficacy of Isazomib in the Treatment of Multiple Myeloma and its Mechanism in SDF1/CXCR4 Axis

目的分析伊沙佐米治疗多发性骨髓瘤的疗效及其在SDF1/CXCR4轴的作用机制。方法选取2019年1月至2021年1月我院收治的多发性骨髓瘤患者68例为研究对象,根据患者治疗方式的不同将患者分为对照组(n=30)和伊沙佐米组(n=38)。对照组患者给予常规治疗,伊沙佐米组患者在常规治疗的基础上加用伊沙佐米。比较两组患者治疗3个疗程后的疾病缓解率及SDF-1、CXCR4变化,并统计不良反应发生情况。结果与对照组比较,伊沙佐米组患者疾病缓解率明显升高(P<0.05)。与对照组比较,伊沙佐米组感染、周围神经病变、Ⅲ级以上血液学毒性等不良反应发生率明显降低(P<0.05)。治疗3个疗程后,伊沙佐米组患者血清SDF-1、CXCR4水平明显降低,且显著低于对照组(P<0.05)。两者患者在消化道反应、乏力、心血管系统等的不良反应发生率比较差异无统计学意义(P>0.05)。结论伊沙佐米治疗多发性骨髓瘤具有较好的疗效,其在提高疗效的同时可以降低治疗过程中感染、周围神经病变、血液学毒性等不良反应的发生;其聚散调节关键点在于SDF1/CXCR4轴,与抑制瘤细胞的增殖、转移有一定关系。

Objective The paper analyzed the efficacy of Isazomib in the treatment of multiple myeloma and its mechanism in SDF1/CXCR4 axis.Methods 68 patients with multiple myeloma admitted in our hospital from January 2019 to January 2021 were selected as the research objects,and the patients were divided into control group(n=30)and Isazomib group(n=38)based on treatment methods.The control group was given conventional treatment,based on which the Isazomib group was treated with Isazomib.After 3 courses of treatment,the remission rate and the changes in SDF-1and CXCR4 of the two groups were compared,and the incidence of adverse reactions was analyzed.Results The remission rate of Isazomib group was significantly higher than the control group(P<0.05),the incidence of infection,peripheral neuropathy and hematological toxicity above gradeⅢin the Isazomib group was significantly lower than the control group(P<0.05).After 3 courses of treatment,the serum levels of SDF-1 and CXCR4 in the Isazomib group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of gastrointestinal reactions,fatigue,cardiovascular system and other adverse reactions between the two groups(P>0.05).Conclusion Isazomib has a good effect in the treatment of multiple myeloma,and it can improve the treatment effect while reducing the incidence of infection,peripheral neuropathy,hematological toxicity and other adverse reactions in the treatment process.The key point of aggregation and dispersion regulation is SDF1/CXCR4 axis,which has a certain relationship with inhibiting the proliferation and metastasis of tumor cells.