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[目的]研究蛋白酶体抑制剂硼替佐米(万珂,Velcade.V)为主的化疗方案治疗多发性骨髓瘤的疗效和不良反应。[方法]18例多发性骨髓瘤患者接受万珂为主的联合方案进行化疗。疗效评定按照EBMT标准。不良反应按美国国立癌症研究所的常规毒性判定标准评价。[结果]18例患者在治疗1个疗程后,12例患者有治疗反应。完成≥4个疗程患者共10例,全部有治疗反应。7例初治患者达到最佳反应所需疗程中位数为2个(1～3个);3例复发难治患者达到最佳反应所需疗程中位数为4个(3～4个)。万珂治疗过程中常见不良反应包括周围神经病变血小板减少、腹泻、呼吸道感染、带状疱疹,在对症处理、延迟化疗后可恢复。随访中位时间11个月(4～22个月),无1例死亡,7例初治患者中5例获得CR/nCR并仍保持CR/nCR状态,2例PR;3例复发难治患者中1例nCR,2例PR。[结论]万珂为主的化疗方案治疗初治和复发难治多发性骨髓瘤,起效较快,疗效较好,不良反应轻,值得推广。
[Objective] To study the efficacy and adverse reactions of the chemotherapy regimen of proteasome inhibitor bortezomib (Velcade.V) in treating multiple myeloma. [Methods] Eighteen patients with multiple myeloma underwent a combination chemotherapy with Velcade. Efficacy evaluation in accordance with the EBMT standard. Adverse reactions according to the United States National Cancer Institute routine toxicity evaluation criteria. [Results] Eighteen patients were treated after one course of treatment, and 12 patients had response to treatment. Complete ≥ 4 courses of treatment in 10 patients, all with therapeutic response. The median treatment course was 2 (1-3) in 7 patients with newly diagnosed patients and 4 (3- 4) in 3 patients with refractory relapsed patients. . Common adverse reactions during the treatment of Velcade Including peripheral neuropathy, thrombocytopenia, diarrhea, respiratory tract infections, shingles, symptomatic treatment, post-chemotherapy can be restored. The median follow-up time was 11 months (range, 4-22 months), none of them died, 5 of 7 newly diagnosed patients achieved CR / nCR and remained CR / nCR, 2 patients had PR; 3 patients with recurrent refractory disease 1 case of nCR, 2 cases of PR. [Conclusion] Vanke-based chemotherapy regimen for the treatment of relapsed and refractory multiple myeloma, rapid onset, good effect, adverse reactions, it is worth promoting.