以免疫调节药为基础方案治疗多发性骨髓瘤相关血栓事件的临床研究  

Clinical study of thromboembolism in multiple myeloma patients with immunomodulatory drugs-based regimens

作　　者：王向东 郭搏 蔡芸[3] 杨天立 朱宏丽 WANG Xiang-dong;GUO Bo;CAI Yun;YANG Tian-Li;ZHU Hong-Li(School of Graduate,Medical School of Chinese People’s Liberation Army,Beijing 100853,China;Department of Hematological,Second Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100853,China;Drug Clinical Research Room,Department of Pharmacy,Medicine Clinical Research Center,Chinese People’s Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院研究生院,北京100853 [2]中国人民解放军总医院第二医学中心血液科,北京100853 [3]中国人民解放军总医院医疗保障中心药剂科药物临床研究室,北京100853

出　　处：《中国临床药理学杂志》2021年第10期1150-1152,共3页The Chinese Journal of Clinical Pharmacology

基　　金：军队保健专项科研课题基金资助项目(16BJZ21);解放军总医院科研扶持基金资助项目(2017FC-TSYS-2023)。

摘　　要：目的观察以免疫调节药(IMiDs)为基础方案治疗多发性骨髓瘤(MM)相关血栓事件(TEs)的发生率及其危险因素分析。方法回顾性分析我院118例接受以IMiDs为基础方案的初诊初治MM患者,分析危险因素与TEs发生的相关性。将死亡作为竞争风险进行竞争性风险生存分析,计算TEs的累积发病率。结果在118例患者,中位年龄为61(31~92)岁,中位随访时间为41.2(4~128)个月,有74例(62.71%)患者接受抗血小板治疗,有1例患者接受抗凝治疗。观察到18例TEs(占全部病例的15.25%),其中静脉TEs 16例(13.56%)、急性下壁心肌梗死和消化道出血事件各1例。血栓累积发生率3个月为5.9%,1年为12.7%,3年为14.4%。单因素分析显示:没有特异性的风险指标能预测TEs。结论接受免疫调节药为基础方案治疗的MM患者血栓发生率较高,并且没有一项特异性指标可以预测血栓风险。Objective To analyse the incidence and risk factors of multiple myeloma(MM) related thrombotic events(TEs) in patients treated with immunomodulatory drugs(IMiDs). Methods This is a retrospective study of 118 newly diagnosed and treated MM patients who received IMiDs-based regimens and the correlation between the risk factors and TEs was analysed. The competing risk model of survival analysis was applied to calculate the cumulative incidence of TEs by taking death as a competitive risk. Results In the 118 patients, the median age was 61(31-92) years, and the median follow-up time was 41.2(4-128) months. A total of 74 patients(62.71%) received antiplatelet therapy and only one patient received anticoagulation therapy. There were 18(15.25%) TEs during the observation period, including 16(13.56%) intravenous TEs, 1 case of acute inferior myocardial infarction and 1 case of gastrointestinal bleeding. The cumulative incidence of thrombosis at 3 months, 1 year and 3 years were 5.9%, 12.7% and 14.4%, respectively. Univariate analysis showed that no specific risk indicator could predict TEs. Conclusion The incidence of thromboembolism is high in MM patients receiving IMiDs-based treatment and there is no specific indicator to predict the risk of thrombosis.

关 键 词：多发性骨髓瘤 免疫调节药 血栓事件 危险因素 血栓预防药物 

分 类 号：R979.5[医药卫生—药品]