硼替佐米减量BDT的方案治疗老年多发性骨髓瘤疗效及安全性分析.docVIP

硼替佐米减量BDT的方案治疗老年多发性骨髓瘤疗效及安全性分析 　　【摘要】 目的：探讨硼替佐米（Bortezomib， Btz）减量的BDT方案治疗老年多发性骨髓瘤（multiple myeloma， MM）的疗效及安全性。方法：回顾性分析2007年10月-2013年10月收治的43例以BDT方案治疗的初治老年MM患者的临床资料，评价不同剂量Btz治疗组的疗效及不良反应。结果：2个疗程后，减量组患者的总有效率为72.0%、CR率28.0%，与标准剂量组（总有效率77.8%、CR率33.3%）比较，差异无统计学意义（P0.05）。Ⅲ级以上不良反应：与标准剂量组相比，减量组的周围神经病变、中性粒细胞减少、感染的发生率明显降低，差异有统计学意义（P0.05）。结论：Btz减量的BDT方案治疗初治老年MM患者的疗效与标准剂量组相似，但不良反应较标准剂量组明显减少，提示具有更好的耐受性。 　　【关键词】 多发性骨髓瘤； 硼替佐米； 沙利度胺； 地塞米松； 老年人 　　【Abstract】 Objective： To discuss the therapeutic effect and safety of the BDT solution quantity of Bortezomib （Btz） for treating multiple myeloma （MM） of the aged. Method： To retrospectively analyze the clinical data of 43 MM patients of the old aged of initial treatment， who accepted from October 2007 to October 2013 and cured with the BDT solution， and evaluate the therapeutic effects and adverse reactions of Btz treatment groups with different dosages. Result： After two courses of treatment， the total effective rate of the patient group with lower quantity was 72.0% and its CR rate was 28.0%， as well as 77.8% of the total effective rate and 33.3% of CR rate of the standard dosage group， there was no statistical significance （P） between the two groups in difference. Adverse reaction higher than Ⅲ level： the generation rates of peripheral neuropathy， neutropenia and infection of the group with lower quantity were obviously decreased compared with those of the standard dosage group， and there was statistical significance in difference （P）. Conclusion： The therapeutic effect of the BDT solution with lower quantity of Btz on the MM patient of the aged of initial treatment is similar as that of the standard dosage group， but the adverse reactions of the BDT solution with lower quantity of Btz are obviously reduced， and better tolerance is available. 　　【Key words】 Multiple myeloma； Bortezomib； Thalidomide； Dexamethasone； Old patient 　　First-author’s address： The Fourth People’s Hospital of Shenyang， Shenyang 110031， China 　　doi：10.3969/