不同剂量硼替佐米联合阿霉素及地塞米松治疗多发性骨髓瘤的疗效及安全性分析  

Efficacy and Safety of Different Doses of Bortezomib Combined with Doxorubicin and Dexamethasone in the Treatment of Multiple Myeloma

作　　者：陈中磊[1] 周进[2] 徐海燕[1] CHEN Zhonglei;ZHOU Jin;XU Haiyan(Suzhou Jiulong Hospital Affiliated to Medical College of Shanghai Jiaotong University,Suzhou,Jiangsu,215000,China;Department of Hematology,First Hospital Affiliated to Suzhou University,Suzhou,Jiangsu,215000,China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院血液科,江苏苏州215000 [2]苏州大学附属第一医院血液科,江苏苏州215000

出　　处：《肿瘤药学》2019年第4期603-606,611,共5页Anti-Tumor Pharmacy

基　　金：苏州市科技计划项目(SYS201308）

摘　　要：目的探讨不同剂量硼替佐米联合阿霉素及地塞米松治疗多发性骨髓瘤的疗效及安全性。方法选取2017年11月-2018年12月我院收治的多发性骨髓瘤患者96例为研究对象,按随机数字表法分为两组,各48例。对照组采用硼替佐米1.3 mg·m^-2、阿霉素10 mg·m^-2以及地塞米松40 mg进行治疗,观察组采用硼替佐米1.0~1.1 mg·m^-2、阿霉素10 mg·m^-2以及地塞米松40 mg进行治疗。对比两组患者的临床疗效、治疗前后血清免疫抑制因子水平及不良反应的发生情况。结果两组临床总缓解率比较,差异无统计学意义(P>0.05);治疗3个疗程后,两组血清IL-6、IL-17、TGF-β水平比较,差异无统计学意义(P>0.05);观察组恶心、呕吐、Ⅲ-Ⅳ级周围神经病变的发生率显著低于对照组(P<0.05)。结论硼替佐米1.3 mg·m^-2与硼替佐米1.0~1.1 mg·m^-2联合阿霉素、地塞米松治疗多发性骨髓瘤的疗效相当,可降低患者血清免疫抑制因子水平,而低剂量硼替佐米的不良反应较少,安全性较高。Objective To investigate the efficacy and safety of different doses of bortezomib combined with doxorubicin and dexamethasone in the treatment of multiple myeloma.Methods Ninety-six patients with multiple myeloma treated in our hospital between November 2017 and December 2018 were enrolled in the study.They were divided into two groups according to the random number table method,48 cases each.The control group was treated with bortezomib 1.3 mg·m^-2,doxorubicin 10 mg·m^-2 and dexamethasone 40 mg.The observation group was treated with bortezomib 1.0~1.1 mg·m^-2,doxorubicin 10 mg·m^-2 and dexamethasone 40 mg.The clinical efficacy of the two groups,the level of immunosuppression before and after treatment,and the incidence of adverse reactions were compared between the two groups.Results There was no significant difference in the total clinical remission rate between the observation group and the control group(P>0.05).The levels of IL-6,IL-17 and TGF-βin the observation group were not significantly different from those in the control group after three courses of treatment(P>0.05).The incidences of nausea and vomiting and gradeⅢ-Ⅳperipheral neuropathy were lower in the observation group than in the control group(P<0.05).Conclusion Bortezomib 1.0~1.1 mg·m^-2 had equivalent efficacy with bortezomib 1.3 mg·m^-2 when combined with doxorubicin and dexamethasone in the treatment of multiple myeloma.Low dose of bortezomib could also reduce the levels of immuno-inhibiting factors,and reduce the incidence of adverse reactions.

关 键 词：硼替佐米 阿霉素 地塞米松 多发性骨髓瘤 疗效 安全性 

分 类 号：R733.3[医药卫生—肿瘤]