Li Jiali,Liu Yao,Zeng Dongfeng,Li Jieping,Chen Xinghua,Zhang Xi,Peng Xiangui,Kong Peiyan.Bortezomib combined with dexamethasone and thalidomide in treatment of multiple myeloma: report of 58 cases[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(24):2515-2517.
Li Jiali,Liu Yao,Zeng Dongfeng,Li Jieping,Chen Xinghua,Zhang Xi,Peng Xiangui,Kong Peiyan.Bortezomib combined with dexamethasone and thalidomide in treatment of multiple myeloma: report of 58 cases[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(24):2515-2517.DOI:
Bortezomib combined with dexamethasone and thalidomide in treatment of multiple myeloma: report of 58 cases
目的 观察硼替佐米联合地塞米松和沙利度胺(VTD)方案对多发性骨髓瘤(multiple myeloma,MM)患者的临床疗效。 方法 收集2008年4月至2012年2月于本院接受VTD方案治疗的58例MM患者临床资料,并以同期30例传统长春新碱+蒽环类+地塞米松+沙利度胺(VADT)方案化疗的MM患者作为对照,分析病情转归及不良反应。患者均完成2个及以上疗程治疗。 结果 随访6个月至2年的MM患者:①VTD用于初治和复发和(或)难治MM患者的总有效率显著高于VADT组(63.8% vs 40.0%,P0.05)。VTD方案中初治患者治疗总有效率显著高于复发和(或)难治患者(77.8% vs 40.9%,P0.05);VTD组治疗初治MM的有效率也明显高于VADT组(36.0%),差异有统计学意义(P0.05)。VTD治疗复发和(或)难治MM的有效率与VADT组(60.0%)无差异(P0.05)。VTD组内轻链型、非轻链型MM患者疗效无显著统计学差异(P0.05)。②VTD治疗不良反应主要有消化道症状、感染、周围神经病变及血小板减少。 结论 硼替佐米联合地塞米松和沙利度胺治疗MM缓解率高,副作用少且一般较轻微,可首选用于治疗初治及复发和(或)难治MM患者。
Abstract
Objective To observe the efficiency of combination of bortezomib plus dexamethasone and thalidomide (VTD) in treatment of multiple myeloma (MM). Methods From April 2008 and February 2012
fifty-eight MM patients underwent VTD treatment in Xinqiao Hospital. A contemporary cohort of 30 MM patients receiving VADT(vincristine+anthracycline+dexamethasone+thalidomide) chemotherapy was set as the control group. The prognosis of disease and adverse effects were analyzed. All subjects were taken chemotherapy in two or more cycles of treatment. All patients were followed up for 6 months to 2 years. Results The total effective rate of the VTD group was 63.8%
significantly higher than of the VADT group (40.0%
P0.05). In VTD treatment
response was 77.8% in newly diagnosed group and 40.9% in relapsed/refractory group (P0.01). The rate of response did not differ between VTD and VADT treatments among relapsed/refractory MM patients (P0.05)
but was higher with VTD treatment than with VADT treatment for newly diagnosed MM patients (77.8% vs 36.0%
P0.05). There was no statistical significance between light chain patients and non-light chain patients in VTD group(P0.05). The adverse effects of VTD were mainly gastrointestinal symptoms infection
peripheral neuropathy and thrombocytopenia. Conclusion VTD treatment is associated with higher rate of remission in treatment of MM
and therefore can be used as a first-line option for newly diagnosed and relapsed/refractory patients.