达雷妥尤单抗联合VTD方案在多发性骨髓瘤患者中的应用效果  

Application effect of daratumumab combined with the VTD regimen in patients with multiple myeloma

作　　者：刘叶珍 普布次仁[2] 李铭锋 周文华 LIU Yezhen;Pubu Ciren;LI Mingfeng;ZHOU Wenhua(Department of Hematology and Oncology,Shangrao Central Hospital,Shangrao 334000,Jiangxi,China;Department of Oncology,the General Hospital of PLA Xizang Military Area Command,Lasa 850007,Xizang,China;Department of Hematology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China)

机构地区：[1]上饶市中心医院血液肿瘤科,江西上饶334000 [2]解放军西藏军区总医院肿瘤科,拉萨850007 [3]南昌大学第一附属医院血液科,南昌330006

出　　处：《癌症进展》2025年第8期889-891,918,共4页Oncology Progress

基　　金：江西省卫生健康委科技计划项目(202410971)。

摘　　要：目的目的探讨达雷妥尤单抗联合硼替佐米+沙利度胺+地塞米松(VTD)方案在多发性骨髓瘤(MM)患者中的应用效果。方法方法根据治疗方式的不同将91例MM患者分为对照组(n=45)和观察组(n=46),对照组患者接受VTD方案治疗,观察组患者接受达雷妥尤单抗联合VTD方案治疗。比较两组患者的临床疗效、骨代谢因子[骨钙蛋白(BGP)、碱性磷酸酶(ALP)、总Ⅰ型前胶原氨基端延长肽(TPINP)]、周围神经病变情况及不良反应发生情况。结果结果观察组患者的总缓解率高于对照组,周围神经病变程度轻于对照组,差异有统计学意义(P﹤0.05)。治疗后,两组患者BGP、ALP、TPINP水平均低于本组治疗前,观察组患者BGP、ALP、TPINP水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者各不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论达雷妥尤单抗联合VTD方案治疗MM患者疗效显著,可改善患者的骨代谢,减轻周围神经病变程度,且不会增加不良反应。Objective To explore the application effect of daratumumab combined with bortezomib+thalidomide+dexamethasone(VTD)regimen in patients with multiple myeloma(MM).Method A total of 91 patients with MM were divided into the control group(n=45)and the observation group(n=46)according to different treatment methods.Patients in the control group were treated with VTD regimen,and patients in the observation group were treated with daratumum-ab and VTD regimen.The clinical efficacy,bone metabolism factors[osteocalcin(BGP),alkaline phosphatase(ALP),to-tal N-terminal propeptide of type I procollagen(TPINP)],peripheral neuropathy conditions and incidence of adverse reac-tions were compared between the two groups.Result The overall response rate in the observation group was higher than that in the control group,and the degree of peripheral neuropathy was milder than that in the control group,and the differ-ences were statistically significant(P<0.05).After treatment,the levels of BGP,ALP and TPINP in both groups were low-er than those before treatment,and the levels of BGP,ALP and TPINP in observation group were lower than those in con-trol group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidences of adverse reactions between the two groups(P>0.05).Conclusion The treatment of MM patients with daratumumab combined with VTD regimen has a significant effect,which can improve the bone metabolism of patients,reduce the degree of peripheral neuropathy,and does not increase adverse reactions.

关 键 词：多发性骨髓瘤 达雷妥尤单抗 VTD方案 骨代谢 不良反应 

分 类 号：R733.3[医药卫生—肿瘤]