硼替佐米在多发性骨髓瘤患者维持治疗中的疗效观察  

Efficacy of Bortezomib for Maintenance therapy of Patients with Multiple Myeloma

作　　者：高丽霞[1] 贾晓玲[1] 胡军[1] 张益枝[1] 吴克雄[1] 傅明伟 王云霞[3] 

机构地区：[1]新疆克拉玛依市中心医院血液肿瘤科,新疆克拉玛依834000 [2]中国医学科学院血液病医院,天津300020 [3]新疆乌鲁木齐市疾病预防控制中心,新疆乌鲁木齐83000

出　　处：《中国实验血液学杂志》2017年第4期1101-1104,共4页Journal of Experimental Hematology

摘　　要：目的:观察以硼替佐米或马法兰为主的化疗方案,在初诊有症状的MM或MP治疗后复发难治性的多发性骨髓瘤(MM)患者维持治疗中的疗效。方法:对本院2008-2013年5年期间MM患者的临床经过及转归进行了回顾性分析。19例初诊有症状的MM(13例),复发难治性的MM患者(6例),以硼替佐米(bortezomib)+地塞米松(Dexamethasone)治疗后进行维持治疗的VD组,17例(初诊有症状的MM),接受马法兰+泼尼松治疗后再进行维持治疗的为MP组,比较两组的疗效。结果:可评估的36例患者,中位随访时间16(1-64)个月,两组患者半年复发率比较差异有统计学意义,VD组19例中半年无1例复发,MP组17例中半年有5例复发(P<0.05)。结论:VD作为MM患者维持治疗的方案优于MP方案,而且毒副作用小。Objective： To observe the efficacy of chemotherapy consisted of bortezomib as main druy in maintenance therapy for recurrence of newly diagnosed MM patients. Methods： The clinical data and outcome of 37 MM patients during 2008-2013 were analyzed retrospectively,the 37 MM patients were divided into 2 group： 19 cases including 13 cases of newly diagnosed MM with symptoms and 6 cases of relapsed refractory MM were enrolled in group A; 17 cases of newly diagnosed MM with symptoms were enrolled in group B. The patients of group A received maintenance therapy consisted of bortezomib plus dexamethasone（ VD group）,while the patient group B received maintenance therapy consisted of melphalan plus prednisone（ MP group）,then the therapeutic efficacy of 2 group was compared. Results：The overall response rate（ ORR） in VD groupe was 84. 2%（ 16/19）,out of which CR rate reached 42%（ 8/19）,PR rate reached 31. 6%（ 6/19）,MR rate reached 10. 5%（ 3/19）. During median follow-up for 21. 8（ 5-51） months,death occurred,while the ORR in MP group was 52（ 9/17）,out of which CR rate was 23. 5%（ 4/17）,PR rate reached23. 5%（ 4/17）,MR rate reached 5. 9%（ 1/17）. Druing median follow-up for 16. 4（ 4-39） months,the worteity reaced64. 7%（ 11/17）. The differencr between 2 groups was significant（ P〈0. 05）. The median OS time of patients in VD group was 21. 6 months,that in MP group was 17. 9 months（ P〈0. 05）. The median PFS in VD group and MP group were 13. 4 and 9. 4 months respectively（ P 0. 001）. Conclusion： The ORR and CR rates of bortezomib maintenance therapy for newly diagnosed and relapsed/refractory MM patients are very high,and its toxicity can be controlled,therefore,the patients need maintenance therapy after remission.

关 键 词：多发性骨髓瘤 硼替佐米 治疗结果 

分 类 号：R733.3[医药卫生—肿瘤]