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1、硼替佐米联合地塞米松治疗多发性骨髓瘤的临床研究?药物与临床?2010年5月第48卷第13期硼替佐米联合地塞米松治疗多发性骨髓瘤的临床研究宋春鸽画宝勇z(1.郑州大学第五附属医院血液肾病内科,河南郑州450052;2.郑州大学公共卫生学院,河南郑州450001)【摘要】目的观察硼替佐米联合地塞米松治疗多发性骨髓瘤(MM)的临床疗效及安全陛.方法12例初治MM患者及6例难治复发患者均采用硼替佐米联合地塞米松化疗(硼替唑米1.3mg/m:,第1,4,8,11天快速静脉注射;地塞米松20～40mg,第1—4,8～11天静脉滴注或口服;3周为1个疗程)1～6
2、个疗程,根据EBMT疗效标准评价疗效,按NCI—CTCAE标准评价不良反应.结果平均随访6个月(2—11个月),12例初治患者中3例完全缓解(cR),6例部分缓解(PR),2例轻微反应(MR),1例无变化(Nc).6例难治复发患者中2例CR,2例PR,1例NR,1例死亡.总反应率(0RR=cR+PR+MR)83.33%.总有效率(CR+PR)72.22%.主要不良反应为乏力,血小板减少,白细胞减少,腹泻,周围神经病变和阵发眭房颤,经对症处理后基本缓解.结论硼替佐米联合地塞米松治疗初发或难治性多发性骨髓瘤是一种有效的新方法,不良反应较轻,患者可耐受.
3、【关键词】硼替佐米;地塞米松;多发性骨髓瘤【中图分类号】R33-3【文献标识码】Af文章编号】1673—9701(2010)13—48—03BortezomibinCombinationwithDexamethasoneforMultipleMyeloma:AClinicalStudySONGChunge'HUABaoyonge1.The5thAffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,China;2.CollegeofPublicHealthofZhengzhouUniversi
4、ty,Zhengzhou450001,China【Abstract】ObjectiveToevaluatetheefficacyandsafetyofbortezomibcombinedwithdexamethasoneinthetreatmentofmultiplemyeloma(MM).MethodsTwelvepatientsnewlydiagnosedasMMand6patientswithrelapsedorrefractoryMMweretreatedwithbortezomibcorn—binedwithdexamethasone(b
5、ortezomib1.3mg/m,dl,4,8,11,dexametllasone20—40rag,dl-4,8—11)in3weeksasacourseoftreatment.Thepatientsreceivedlto6COUrsesoftreatment.ResponsewasevaluatedaccordingtotheEBMTcriteriaandadversereactionsweregradedaccord-ingtotheNCI—CTCAE(versi0n3.0).ResultsThe6-month(2-11months)media
6、nfollow-upshowedoutofthe12patientsnewlydiagnosedMM,twoachievedcompleteresponse(CR),sixpartialresponse(PR),threeminorresponse(MR)andnochangeforone.The6patientswithre-fractory/relapsedmyelomaachievedCR(2/6),PR(2/6),NR(1/6)andonedied.Clinicalresponseratewas83.33%).Theoverallrespo
7、nserate(CR+PR)was72.22%.Themostadverseeventsobservedwerefatigue(11/18,61.11%),thrombocytopenia(5/18,27.67%),neutropenia(2118,11.11%),diarrhea(3/18,16.67%),peripheralneuropathy(3/18,16.67%)andparoxysmalatrialfibrillation(1/18,5.56%).ConclusionBone-zomibcombinedwithdexamethasone
8、isanewandeffectivetreatmentforMMpatients,withmildadversereact
