伊沙佐米联合方案治疗多发性骨髓瘤的效果及预后影响因素分析  

Effect of ixazomib combination treatment therapies on multiple myeloma and the prognostic influencing factors

作　　者：唐云龙 苗雨青 陈益飞[3] 刘佳琦 周燕[1] 孙乃同 李红叶 Tang Yunlong;Miao Yuqing;Chen Yifei;Liu Jiaqi;Zhou Yan;Sun Naitong;Li Hongye(Department of Hematology,Yancheng School of Clinical Medical of Nanjing Medical University,Yancheng Third People's Hospital,Yancheng 224000,China;Department of Hematology,Yancheng First People's Hospital,Yancheng 224000,China;Department of Hematology,Yangzhou Jiangdu People's Hospital,Yangzhou 225000,China;Medical School,Nantong University,Nantong 226000,China)

机构地区：[1]南京医科大学盐城临床医学院,盐城市第三人民医院血液内科,盐城224000 [2]盐城市第一人民医院血液内科,盐城224000 [3]扬州市江都人民医院血液内科,扬州225000 [4]南通大学医学院,南通226000

出　　处：《肿瘤研究与临床》2023年第12期910-914,共5页Cancer Research and Clinic

基　　金：盐城市卫生科技发展计划(YK2019097)。

摘　　要：目的探讨伊沙佐米联合方案治疗多发性骨髓瘤(MM)的效果及预后影响因素。方法回顾性分析盐城市第三人民医院2020年1月至2022年1月收治的80例MM患者的临床资料,所有患者均接受伊沙佐米联合方案治疗3个疗程(28 d为1个疗程),按联合方案分为ID组(伊沙佐米+地塞米松)11例、ID+免疫调节剂组(伊沙佐米+地塞米松+来那度胺/沙利度胺)50例、ID+其他化疗药物组(伊沙佐米+地塞米松+多柔比星脂质体/环磷酰胺/苯达莫司汀)19例。对比不同方案组患者的临床疗效,同时随访并记录预后情况,比较生存和死亡患者间临床特征,采用Cox比例风险模型对伊沙佐米联合方案治疗的MM患者总生存进行多因素分析。结果ID组治疗有效9例(81.82%),ID+免疫调节剂组治疗有效32例(64.00%),ID+其他化疗药物组治疗有效9例(47.37%),3组有效率比较,差异无统计学意义(χ^(2)=0.62,P=0.432)。80例患者随访(15±4)个月,范围5~20个月,49例生存与31例死亡患者间免疫球蛋白类型、Durie-Salmon分期、前期治疗线数和治疗效果分层患者构成比较,差异均有统计学意义(均P<0.05)。多因素Cox回归分析显示,临床治疗有效(有效比无效:OR=0.242,95%CI 0.103~0.567,P=0.001)和前期接受一线治疗(一线比其他线:OR=0.577,95%CI 0.452~0.736,P<0.001)均为患者总生存的独立保护因素。结论3种伊沙佐米联合方案治疗MM均具有一定疗效,ID方案的临床疗效和生存最优,而临床治疗有效和前期接受一线治疗均为MM生存的独立保护因素。Objective To explore the efficacy of ixazomib combination treatment therapies for multiple myeloma(MM),and the influencing factors of prognosis.Methods The clinical data of 80 MM patients admitted to Yancheng Third People's Hospital from January 2020 to January 2022 were retrospectively analyzed.All patients received 3 courses of ixazomib combination treatment therapies(28 d was 1 course).All combination treatment therapies included ID group(ixazomib+dexamethasone,11 cases)and ID+immunomodulator group(ixazomib+dexamethasone+lenalidomide/thalidomide,50 cases),ID+other chemotherapy drugs group(ixazzomib+dexamethasone+doxorubicin liposome/cyclophosphamide/bendamustine,19 cases).The clinical efficacy of patients in different treatment regimens was compared,and the prognosis was followed up and recorded.The clinical characteristics between the survival and the dead patients were compared.Cox proportional risk model was used to make multivariate analysis of the overall survival of MM patients receiving ixazomib combination therapies.Results The treatment was effective in 9 cases(81.82%)of the ID group,32 cases(64.00%)of the ID+immunomodulator group,and 9 cases(47.37%)of the ID+other chemotherapy drugs group.There was no statistically significant difference in the effectiveness rate of 3 ixazomib combination regimens(χ^(2)=0.62,P=0.432).All patients were followed up for 5 to 20 months,with an average follow-up time of(15±4)months.There were statistically significant differences in immunoglobulin type,Durie-Salmon stage,early treatment line and therapeutic efficacy between the survival group(49 cases)and the death group(31 cases)(all P<0.05).Multivariate Cox regression analysis showed that the clinical effectiveness(effectiveness vs.ineffectiveness:OR=0.242,95%CI 0.103-0.567,P=0.001)and the previous first-line treatment(the first-line vs.the other lines:OR=0.577,95%CI 0.452-0.736,P<0.001)were independent protective factors for the overall survival of MM.Conclusions The 3 ixazomib combination therapies have a certain ef

关 键 词：多发性骨髓瘤 伊沙佐米 治疗结果 预后 

分 类 号：R733.3[医药卫生—肿瘤]