多发性骨髓瘤治疗中BD方案、PAD方案的应用对病人生存状况影响及安全性对比研究

Comparative study on the effects of BD regimen and PAD regimen on patients′survival status and safety in the treatment of multiple myeloma

目的:对比多发性骨髓瘤治疗中硼替佐米联合地塞米松(BD)方案、硼替佐米联合表阿霉素、地塞米松(PAD)方案的应用对病人生存状况影响及安全性。方法:回顾性选取2018年1月至2021年3月收治的多发性骨髓瘤病人80例,根据治疗方案将病人分为BD组和PAD组,BD组42例,PAD组38例。比较2组病人治疗效果、治疗前后血清指标、生存状况、不良反应情况。结果:2组病人治疗前血红蛋白、血清肌酐、β微球蛋白、骨髓浆细胞比例、M蛋白、治疗后骨髓浆细胞比例、总生存期进行比较,差异无统计学意义(P>0.05),2组病人治疗后血红蛋白升高且治疗后PAD组血红蛋白高于BD组(P<0.05),2组病人治疗后血清肌酐、β微球蛋白、骨髓浆细胞比例、M蛋白均降低(P<0.05),且PAD组治疗后血清肌酐、β微球蛋白、M蛋白降低幅度更大(P<0.05)。PAD组病人总有效率86.84%,高于BD组的64.29%(P<0.05),PAD组无进展生存期较BD组更长(P<0.05)。PAD组血小板减少、粒细胞减少、黏膜炎、手足麻木总不良反应率,与BD组比较,差异无统计学意义(P>0.05)。结论:治疗多发性骨髓瘤采用PAD方案与BD方案比较,不良反应无明显差异,PAD方案治疗效果更好,无进展生存期更长,不良反应更少。

Objective:To compare the effects of bortezomib combined with dexamethasone(BD)regimen and bortezomib combined with epirubicin and dexamethasone(PAD)regimen on patients′survival status and safety in the treatment of multiple myeloma.Methods:From January 2018 to March 2021,80 patients with multiple myeloma were retrospectively selected,and divided into the BD group(42 cases)and PAD group(38 cases)according to the treatment plan.The therapeutic effect,serum indexes before and after treatment,survival status and adverse reactions were compared between two groups.Results:There was no statistical significance in the levels of hemoglobin,serum creatinine,βmicroglobulin,bone marrow plasma cell ratio and M protein before treatment,and levels of bone marrow plasma cells ratio and overall survival after treatment between two groups(P>0.05).After treatment,the hemoglobin levels in two groups increased,and the hemoglobin in the PAD group was higher than that in BD group(P<0.05).After treatment,the serum creatinine,βmicroglobulin,bone marrow plasma cell ratio and M protein in two groups decreased(P<0.05),and the levels of serum creatinine,βmicroglobulin and M protein in the PAD group decreased significantly compared with the BD group(P<0.05).The total effective rate in the PAD group was 86.84%,which was higher than that in BD group(64.29%)(P<0.05),and the progression-free survival in the PAD group was longer than that in BD group(P<0.05).The difference of total adverse reaction rate of thrombocytopenia,granulocytopenia,mucositis,and numbness of hands and feet difference of was not statistically significant between PAD group and BD group(P>0.05).Conclusions:In the treatment of multiple myeloma,there is no significant difference in the adverse reactions between PAD regimen and BD regimen.The PAD regimen has better therapeutic effect,longer progression-free survival and fewer adverse reactions.