摘要
本研究探讨硼替佐米联合甲泼尼龙治疗复发、难治性多发性骨髓瘤的疗效及不良反应。33例复发/难治性MM进行了回顾性分析,33例中男性23例,女性10例,中位年龄57岁(38-85)岁。中位疾病诊断时间为25(2-120)个月。所有患者均应用硼替佐米(0.9-1.1)m g/m2,第1、4、8、11天给药,同时在第1、4、8、11天联合应用甲泼尼龙40m g/d(4例),80m g/d(13例),120m g/d(2例),200m g/d(9例),300m g/d(5例)。中位随访时间10(3-60)个月,应用疗程数1-8个(平均4个)。结果表明,24例获得不同程度的缓解,总有效率为72.7%(24/33)。32例患者完成了2个或2个以上疗程的治疗,总有效率为71.9%(23/32例)。16例完成了4个疗程的治疗,总有效率93.8%(15/16例)。7例完成了6个疗程的治疗,总有效率为100%(7/7例)。主要的不良反应为血小板减少,感染和周围神经病变。33例患者的中位生存时间为41.5(2-120)个月,2年总体生存率(O S)为80%,3年O S为59.1%,5年O S为21.1%。结论:采用硼替佐米联合甲泼尼龙治疗复发、难治性MM患者的疗效确切,而且起效迅速,缓解率高,不良反应较轻。
The aim of this study was to explore the clinical effect and toxicity of bortezomib combined with methylprednisolone in treatment of relapsed or refractory multiple myeloma （MM）. Clinical data of 33 patients （23 male, 10 female; aged from 38 to 85 years old） were analyzed retrospectively. The median diagnosis time was 25 （2 - 120） months. 33 patients received bortezomib （0. 9 -1. 1） mg/m2 on days 1, 4, 8, 11, in combination with methylprednisolone 40 mg/d （4 cases）, 80mg/d （13 cases）, 120 mg/d （2 cases）, 200 mg/d （9 cases）, 300 mg/d （5 cases） respectively. The median follow-up time was 10（3 -60） months. The used therapy courses were 1 -8 （mean 4 courses）. The results indicated that 24 cases showed the response of different degree, the overall response rate （ORR） was 72.7% （24/33）. 32 patients received I〉2 therapy courses, and ORR was 71.9% （23/32）. 16 patients received 4 therapy courses, and ORR was 93.8% （ 15/16 cases）. 7 patients received 6 therapy courses and the ORR was 100% （7/7 cases）. Main side-effects were thrombocytopenia, infection and peripheral neuropathy. The median survival time was 41.5 （2 - 120） months and the 2-year, 3-year and 5-year overall survival rate were 80%, 59.1% and 21.1%, respectively. It is concluded that bortezomib combined with methylprednisolone is an effective therapy with higher response rate, and safe in treatment of relapsed or refractory multiple myeloma.
出处
《中国实验血液学杂志》
CAS
CSCD
2011年第4期987-990,共4页
Journal of Experimental Hematology
