复发难治性多发性骨髓瘤患者应用含达雷妥尤单抗方案的效果观察及疾病缓解影响因素分析

Effect Observation and Analysis of Factors Affecting Disease Remission of Patients with Relapsed and RefractoryMultiple Myeloma Treated with Daretozumab

目的:探讨达雷妥尤单抗方案治疗复发难治性多发性骨髓瘤(RRMM)的临床疗效及安全性,并分析影响疾病缓解的相关因素。方法:回顾性分析2019年1月~2022年9月新疆维吾尔自治区人民医院血液科收治的接受达雷妥尤单抗治疗的50例RRMM患者临床资料。结果:治疗后患者血红蛋白(Hb)、乳酸脱氢酶(LDH)、β2微球蛋白(β2-MG)、血肌酐(Scr)水平均较治疗前明显改善义(P<0.05)。临床总有效率(ORR)为70.9%,无进展生存期(PFS)为11月。两组在年龄、复发次数、溶骨性病变比例上比较有统计学意义(P<0.05),而在性别、免疫分型、HRCA、贫血、肾损害、髓外病变比例上比较无统计学意义(P>0.05)。疾病缓解组与未缓解组在年龄、复发次数、溶骨性病变比例上比较有统计学意义(P<0.05),而在性别、免疫分型、HRCA、贫血、肾损害、髓外病变比例上比较无统计学意义(P>0.05)。多因素Logistic回归分析显示,复发次数是影响达雷妥尤单抗方案治疗缓解率的危险因素(P=0.019,OR=1.956)。结论:含达雷妥尤单抗方案治疗RRMM具有较好的疗效及安全性,其疗效可受到复发次数的影响。

Objective:To explore the clinical efficacy and safety of daretozumab regimen in the treatment of relapsed refractory multiple myeloma(RRMM),and analyze the related factors affecting the remission of the disease.Methods:The clinical data of 50 RRMM patients treated with daretozumab in the Hematology Department of the People's Hospital of Xinjiang Uygur Autonomous Region from January 2019 to September 2022 were analyzed retrospectively.Results:After treatment,the levels of hemoglobin(Hb),lactate dehydrogenase(LDH),β2 microglobulin(β2-mg)and serum creatinine(Scr)were improved compared with those before treatment(P<0.05).The overall clinical response rate(ORR)was 70.9%,and the progression-free survival(PFS)was 11 months.There were statistical significance in age,recurrence times and proportion of osteolytic lesions between the two groups(P<0.05),but there were no statistical significance in gender,immune classification,HRCA,anemia,kidney damage and proportion of extramedullary lesions between the two groups(P>0.05).There were statistically significant differences in age,recurrence times and proportion of osteolytic lesions between the remission group and the non-remission group(P<0.05),but no statistically significant differences in gender,immune classification,HRCA,anemia,kidney damage and proportion of extramedullary lesions between the two groups(P>0.05).Multivariate Logistic regression analysis showed that the number of recurrence was a risk factor for the response rate of darettuzumab regimen(P=0.019,OR=1.956).Conclusion:The regimen containing daretozumab in the treatment of RRMM has good efficacy and safety,and its efficacy can be affected by the number of recurrences.