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目的:观察硼替佐米治疗多发性骨髓瘤(MM)的疗效及不良反应。方法:5例初治的MM患者接受硼替佐米联合地塞米松治疗,6例复发难治骨髓瘤患者接受VDT方案(硼替佐米+地塞米松+反应停)化疗,每例患者至少接受中位3个周期(1～6个周期)的化疗。评价疗效及不良反应。结果:中位随访9个月,5例初治患者中2例完全缓解(CR),2例部分缓解(PR),1例轻微缓解(MR);6例复发难治患者中,3例PR,1例MR,2例无改变(NC)。总反应率(ORR=CR+PR+MR)为81.8%(9/11)。主要不良反应:10例(90.9%)胃肠道症状,8例(72.7%)血小板减少,7例(63.6%)白细胞减少,4例(36.3%)周围神经病变等,经对症治疗及调整用药剂量后均能改善。结论:硼替佐米用于治疗初发及复发难治MM是一种有效的新的治疗选择,不良反应较少且易于处理。
Objective: To observe the efficacy and adverse reactions of bortezomib in the treatment of multiple myeloma (MM). Methods: Five patients with untreated MM were treated with bortezomib plus dexamethasone, and six patients with relapsed / refractory myeloma underwent VDT (bortezomib + dexamethasone + response) chemotherapy. Each patient received at least Bit 3 cycles (1 to 6 cycles) of chemotherapy. Evaluation of efficacy and adverse reactions. Results: After a median follow-up of 9 months, 2 of 5 newly diagnosed patients were completely relieved (CR), 2 partially relieved (PR) and 1 slightly relieved (MR). Of the 6 patients with refractory or relapsed disease, 3 , One case of MR, and two cases of no change (NC). The overall response rate (ORR = CR + PR + MR) was 81.8% (9/11). The main adverse reactions were gastrointestinal symptoms in 10 patients (90.9%), thrombocytopenia in 8 patients (72.7%), leukopenia in 7 patients (63.6%) and peripheral neuropathy in 4 patients (36.3%). After symptomatic treatment and adjustment After the dose can be improved. CONCLUSION: Bortezomib is a new and effective treatment option for the treatment of refractory and recurrent refractory MM, with fewer adverse reactions and ease of management.