论文部分内容阅读
目的观察伐昔洛韦预防多发性骨髓瘤(MM)患者应用含硼替佐米的化疗方案的治疗过程中带状疱疹的发生率及不良反应。方法 53例MM初治患者均接受含硼替佐米化疗方案治疗(硼替佐米1.3 mg/m2,沙利度胺100 mg qn,地塞米松20 mg,第1~4天)。随机选取26例患者给予应用伐昔洛韦预防性抗病毒治疗。伐昔洛韦300 mg,每日2次经口服给药,至硼替佐米化疗3~4个疗程后停药。其余27例患者未接受伐昔洛韦预防治疗。结果 26例接受伐昔洛韦预防治疗的患者均未发生带状疱疹。27例未预防患者中有5例出现带状疱疹。两组患者治疗反应率相似,加用伐昔洛韦治疗组主要不良反应为消化道反应和乏力。结论含硼替佐米方案治疗MM存在较高的疱疹病毒感染风险,伐昔洛韦可有效预防疱疹病毒的发生,且对原发疾病治疗反应率无影响,患者耐受性良好,不良反应少。
Objective To observe the incidence and adverse reactions of valacyclovir in the treatment of patients with multiple myeloma (MM) who received chemotherapy regimen containing bortezomib. Methods Fifty-three patients with MM-naive patients received bortezomib chemotherapy (bortezomib 1.3 mg / m2, thalidomide 100 mg qn, dexamethasone 20 mg, days 1-4). Twenty-six patients were randomized to receive valacyclovir prophylactic antiviral therapy. Valaciclovir 300 mg, 2 times a day by oral administration to bortezomib chemotherapy after 3 to 4 courses of withdrawal. The remaining 27 patients did not receive valacyclovir prophylaxis. Results None of the 26 patients who received valacyclovir prophylaxis had shingles. Shingles appear in 5 of 27 unprotected patients. The two groups of patients with similar response rates, plus valacyclovir treatment group, the main adverse reactions of gastrointestinal reactions and fatigue. CONCLUSION: Bortezomib has a high risk of herpes simplex virus infection in the treatment of MM. Valaciclovir can effectively prevent the herpes virus and has no effect on the response rate of the primary disease. The patient is well tolerated and has few adverse reactions.