硼替佐米联合地塞米松和沙利度胺治疗多发性骨髓瘤的临床疗效

Clinical effect of bortezomib combined with dexamethasone and thalidomide on treatment of multiple myeloma

  • 摘要: 目的:观察硼替佐米联合地塞米松和沙利度胺(BDT)方案对多发性骨髓瘤(MM)患者的临床疗效。方法收集2009年3月-2012年3月在本院接受VTD方案治疗的73例MM患者临床资料,并以同期40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。所有患者均随访6月~2年,分析病情转归及不良反应。结果VTD用于初治和复发和(或)难治MM患者OR明显高于VADT组(P<0.05)。VTD组初治MM的OR也明显高于VADT组(P<0.05)。VTD治疗复发和(或)难治MM的有效率与VADT组无明显差异(P>0.05)。VTD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,副作用少且轻微,可首选用于治疗初治及复发和(或)难治MM患者。

     

    Abstract: Obj ective To observe the efficacy of bortezomib combined with dexamethasone and thalidomide (VTD)in treatment of multiple myeloma (MM).Methods 73 MM patients un-derwent VTD treatment were analyzed.A contemporary cohort of 40 MM patients with VADT chemotherapy was designed as the control group.The prognosis of disease and adverse effects were analyzed.All patients were followed up for 6 months to 2 years.Results The total effective rate of the VTD group was 67 .1%,which was significantly higher than 42 .5%of the VADT group (P<0 .05 ).The rate of response did not differ between VTD and VADT treatments among relapsed/refractory MM patients (P>0 .05 ),but was higher with VTD treatment than that with VADT treatment for newly diagnosed MM patients (P<0 .05 ).The adverse effects of VTD were gastroin-testinal infection,peripheral neuropathy and thrombocytopenia.Conclusion VTD treatment is as-sociated with higher rate of remission in treatment of MM,and therefore it can be used as a first-line option for newly diagnosed and relapsed/refractory patients.

     

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