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目的观察硼替佐米治疗多发性骨髓瘤(multiple myeloma,MM)的疗效及血液学指标的改变。方法2007年4月至2009年12月本院血液病中心收治的18例多发性骨髓瘤患者,其中7例初治患者与11例复发难治患者,均采用以硼替佐米为主的联合方案化疗,3周为1个疗程,每例患者至少接受1～6个疗程的治疗。观察疗效及相关血液学指标的改变。结果7例初治患者中5例患者完全缓解(CR),后1例行自体造血干细胞移植,2例患者获得部分缓解(PR)。11例复发难治患者中7例达CR,2例达PR,2例无效。患者浆细胞比例、血清总蛋白含量(TP)、球蛋白(G)、M蛋白含量、尿蛋白、β2-微球蛋白、乳酸脱氢酶(LDH)、肌酐(Cr)、尿酸(UA)等随化疗周期呈明显下降趋势,患者血红蛋白(Hb)、白蛋白(Alb)含量、A/G比值等呈明显的上升趋势。不良反应多为1～2级,常为一过性,包括周围神经病变(4/18)、骨痛(1/18)、胃肠道反应(8/18),经对症治疗后均好转。结论硼替佐米对初发及难治复发多发性骨髓瘤的治疗均有较好疗效,对治疗相关不良反应患者可耐受,相关血液学指标改善明显。
Objective To observe the curative effect and hematological changes of bortezomib in treating multiple myeloma (MM). Methods From April 2007 to December 2009, 18 patients with multiple myeloma were admitted to the Hematology Center of our hospital. Among them, 7 patients with initial treatment and 11 patients with refractory relapse were treated with bortezomib-based combination regimen Chemotherapy, 3 weeks for a course of treatment, each patient received at least 1 to 6 courses of treatment. Observed the efficacy and related hematological changes. Results Of the 7 newly diagnosed patients, 5 patients achieved complete remission (CR), 1 received autologous hematopoietic stem cell transplantation and 2 received partial remission (PR). Of the 11 patients with refractory relapse, 7 were CR, 2 were PR, and 2 were ineffective. The proportion of plasma cells, serum total protein (TP), globulin (G), M protein, urinary protein, β2-microglobulin, lactate dehydrogenase (LDH), creatinine (Cr), uric acid With the decreasing trend of the chemotherapy cycle, the Hb, Alb and A / G ratios of patients showed a significant upward trend. Adverse reactions mostly 1 to 2, often transient, including peripheral neuropathy (4/18), bone pain (1/18), gastrointestinal reactions (8/18), after symptomatic treatment were improved. Conclusion Bortezomib has a good curative effect on the treatment of primary and refractory relapsed multiple myeloma and is tolerable to the treatment-related adverse reactions. The relevant hematological indexes are improved obviously.