PDD方案治疗初治多发性骨髓瘤的临床研究  

PDD Regimen for the Treatment of Patients with Initially Diagnosed Multiple Myeloma

作　　者：周亚南[1] 陈子兴[1] 张日[1] 张旭辉[1] 陶瑞芳[1] 邵景章[1] 吴德沛[1] 

机构地区：[1]苏州大学附属第一医院 江苏省血液研究所 卫生部血栓与止血重点实验室,江苏苏州215006

出　　处：《中国血液流变学杂志》2014年第3期373-375,397,共4页Chinese Journal of Hemorheology

摘　　要：目的：观察硼替佐米联合脂质体多柔比星和地塞米松（PDD）方案治疗初治多发性骨髓瘤（MM）的疗效。方法回顾性分析26例初治MM，采用PDD方案：硼替佐米1.3 mg/m2，第1、4、8、11天，脂质体多柔比星40 mg，第1天，地塞米松20 mg，第1-2，4-5，8-9，11-12天，每4周1个疗程，共2-6个疗程，观察疗效和不良反应。结果平均接受（4.1±1.1）（2-6）个疗程，有效率为25例（96%），2个疗程有效率23例（88%）。26例2个疗程达严格意义完全缓解（sCR）4例（15%），完全缓解（CR）8例（31%），非常好的部分缓解（VGPR）8例（31%），部分缓解（PR）3例（12%），轻微反应（MR）2例（8%），疾病稳定（SD）1例（4%）。骨髓瘤细胞、血清单克隆M蛋白均较治疗前下降。最常见不良反应为血液学改变，血小板减少、中性粒细胞减少、贫血；其次为胃肠道反应，便秘。另外，周围神经病变（PN）较为多见。结论PDD方案治疗初治MM具有良好的临床疗效和安全性。Objective To evaluate the efficacy of bortezomib combined with liposomal doxorubicin and dexamethasone （PDD） regimen in treating the initially diagnosed multiple myeloma （MM）. Methods Twenty-six patients＆#39; chemotherapy was conducted with PDD regimen every 4 weeks, for 2 to 6 course. Bortezomib was given at the dose of 1.3 mg/m2 on day 1, 4, 8, 11;liposomal doxorubicin 40 mg on day 1;dexamethasone 20 mg on day 1-2, 4-5, 8-9, 11-12. The efficacy and the toxicity were observed. Results After 2-6 （4.1±1.1） courses of treatment, the total efficacy rate was 25 cases （96%）. After 2 courses of treatment, the overall efficacy was 23 cases （88%）. In those cases, the strictest complete remission 4 cases （15%）, complete remission 8 cases （31%）, very good partial remission was 4 cases （15%）, partial remission 3 cases （12%）, minimal response 2 cases （8%）, stable disease 1 case （4%）. Bone marrow plasma cells, serum monoclonal protein were decreased. The most common toxicities were hematologic toxicities included thrombocytopenia, neutropenia, and anemia. Gastrointestinal symptoms toxicity was constipation. Peripheral neuropathy （PN） was relatively common. Conclusion PDD regimen can be successfully applied to the therapy of initially diagnosed multiple myeloma with mild toxicity.

关 键 词：多发性骨髓瘤 硼替佐米 脂质体多柔比星 地塞米松 初治 

分 类 号：R733.3[医药卫生—肿瘤]