间断口服伐昔洛韦预防多发性骨髓瘤患者应用硼替佐米致带状疱疹的临床观察  

Intermittent administration of valacyclovir is effective for prevention of herpes zoster events in patients with multiple myeloma treated with bortezomib

作　　者：姚一芸[1] 唐勇[1] 庄衍[1] 汪蕾[1] 邹丽芳[1] 朱琦[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院血液内科,上海200011

出　　处：《中国癌症杂志》2014年第7期525-528,共4页China Oncology

基　　金：上海市自然基金(No:12ZR1416800)

摘　　要：背景与目的:随着硼替佐米成功用于多发性骨髓瘤的治疗,药物导致带状疱疹激活现象受到关注。本研究探讨硼替佐米治疗期间伐昔洛韦不同用药方法预防带状疱疹的效果。方法:31例多发性骨髓瘤患者随机分成伐昔洛韦间断应用组和连续应用组,分别观察2组患者带状疱疹发生情况、药物不良反应、抗病毒治疗费用及情绪状态。结果:2组患者治疗期间均未合并带状疱疹,未发生3级以上药物不良反应,间断用药组的抗病毒费用支出低于连续治疗组。患者情绪取决于基础疾病疗效,既往治疗不理想的连续用药组患者有焦虑抑郁表现。结论:伐昔洛韦间断应用能够有效预防硼替佐米治疗期间多发性骨髓瘤患者带状疱疹发生。Background and purpose：Herpes zoster is a common adverse event associated with the use of bortezomib. The objective of this study was to evaluate the efifcacy of different therapeutic regimens of valacyclovir prophylaxis： continuously administration and intermittent administration. Methods： We retrospectively analyzed the efficacy, side effects, expense of valacyclovir and emotional states of 31 patients with multiple myeloma who received bortezomib and valacyclovir prophylaxis. Among them, 14 patients underwent continuously administration of valacyclovir, the other 17 patients underwent intermittent administration. Continuously administration was deifned as daily oral valacyclovir 600 mg without cessation during entire period of bortezomib treatment. Intermittent administration was deifned as patients received valacyclovir at a dose of 600 mg daily during chemotherapy, while discontinue valacyclovir at the intermission time of bortezomib treatment. Results： There were no herpes zoster in patients of 2 arms. Adverse events over grade 3 associated with valacyclovir were not observed. Intermittent administration of valacyclovir showed a superiority of economic beneift. The emotional status were depended on the therapeutic effects of multiple myeloma. For those relapsed or refractory patients, continuously administration of valacyclovir might aggravate depression and anxiety. Conclusion：Intermittent administration of valacyclovir at a dose of 600 mg daily appears to be an effective prophylaxis for herpes zoster in patients receiving bortezomib.

关 键 词：多发性骨髓瘤 硼替佐米 带状疱疹 伐昔洛韦 

分 类 号：R738.1[医药卫生—肿瘤]