摘要
目的观察硼替佐米联合地塞米松(PD)方案治疗初治多发性骨髓瘤(MM)的疗效和不良反应。方法 2009年9月至2011年12月收集安康市中心医院MM患者16例,均给予PD方案为一线治疗:硼替佐米1.3mg/m2,静脉注射,第l、4、8、1l天;地塞米松20mg/d,静脉滴注,第1～4,8～11天。每3周为1个周期,所有患者至少接受1个疗程的治疗。采用国际骨髓瘤工作组(IMWG)标准观察疗效和不良反应。结果患者接受1～6个疗程的治疗后,总有效率为94%,其中完全缓解(CR)9例(56%),非常好的部分缓解(VGPR)1例(6%),部分缓解(PR)3例(19%),轻微反应(MR)2例(13%),疾病稳定(SD)1例(6%)。可见初始疗效的中位时间为3(1～5)周。最常见的不良反应为胃肠道症状,其中便秘6例(38%),恶心、呕吐3例(19%);其次为血液学改变,血小板减少5例(31%);另外,周围神经病变6例(38%),乏力3例(19%);给予对症处理后均好转。结论 PD方案治疗初治MM患者疗效明确,不良反应较轻且大多可逆,具有较好的耐受性。
Objective To investigate the efficacy and toxicity of Bortezomib in combination with Dexanethasone （PD） for the initial treatment of multiple myeloma （MM）. Methods Sixteen patients with MM, who were hospitalized in Ankang city central hospital from September 2009 to December 2011, were treated with Bortezomib （1.3 mg/m2） by intravenous bolus for 2 weeks in a 21-day cycle, followed by an intravenous injection of Dexanethasone 20 mg. The patients at least received 2 courses of treatment. Response and adverse effects to Bortezomib was evaluated according to the criteria of International Myeloma Working Group （IMWG） before the initiation of each bortezomib chemotherapy. Results Sixteen patients were given with Bortezomib for a maximum of 6 cycles. The median follow-up duration from the beginning of bortezomib treatment was 3 weeks. Clinical response was observed in 15 patients （94%）, including complete response in 9 （56%） patients, very good partial response in 1 （6%） patient, partial response in 3 （19%） patients, minimal response in 2 （13%） patients and stable disease in 1 （6%） patients. The most common adverse reactions were gastrointestinal systems （6 patients）, peripheral neuropathy （6 patients）, and fatigue （3 patients）. Conclusions Bortezomib in combination with Dexanethasone is an effective therapy with a high response rate for MM in the initial treatment. Adverse reaction is mild and mostly reversible. The patients had a good tolerance to this treatment.
出处
《热带医学杂志》
CAS
2012年第8期990-991,1010,共3页
Journal of Tropical Medicine
关键词
多发性骨髓瘤
硼替佐米
地塞米松
初治
multiple myeloma
Bortezomib
Dexanethasone
initial treatment
