【作者】 夏永明；

【导师】 金洁；

【作者基本信息】 浙江大学 ， 内科学， 2010， 硕士

【摘要】 目的：观察硼替佐米联合地塞米松方案治疗18例初治多发性骨髓瘤的疗效、不良反应。方法：观察2006年12月至2009年2月18例初治多发性骨髓瘤患者接受硼替佐米联合地塞米松方案(VD方案)方案治疗后的疗效与不良反应。所有患者至少接受一个疗程治疗。18例患者中男性1 1例,女性7例,初诊年龄41-85岁,中位年龄63.7岁。采用Durie-Salmon分期系统：Ⅱ期1例,Ⅲ期17例,采用ISS进行分期：Ⅰ5例,Ⅱ期9例,Ⅲ期4例。治疗方案为硼替佐米1.3mg/m2,静脉滴注,第1、4、8、11天,地塞米松20-40 mg/d,第1、2、4、5、8、9、11、12天,3周为一疗程。临床疗效根据2008年中国多发性骨髓瘤工作组制定的疗效标准来评价。结果：18例患者治疗后疗效评估分别为：CR+VGPR4/18(22.2%),PR11/18(61.1％), MR1/18(5.6%),NC2/18(11.1％),总有效(ORR,overall response rate)为CR +VGPR+PR达到83.3%。贫血及肾功能损害得到明显改善。出现的不良反应包括血液学毒性7/18例(其中Ⅰ级1例,Ⅱ级4例,Ⅲ级2例),周围神经病变10/18例(其中Ⅰ级3例,Ⅱ级2例,Ⅲ级1例,Ⅳ级4例),乏力4/18例,感染9/18(带状疱疹4/18例,肺部感染6/18例),便秘3/18例,肠梗阻2/18例,上述不良反应均在对症处理或停药后恢复或减轻。结论：本研究中硼替佐米联和地塞米松联合方案治疗多发性骨髓总效率为83.3%,不良反应较轻且大多可逆,具有较好的耐受性。更多还原

【Abstract】 Objective:To evaluate the safety and activity of Bortezomib in combination with Dexamethasone in de nove Multiple Myeloma.Method:Eighteen de nove MM patients received treatment of Bortezomib combined with dexamethasone between December of 2006 to February of 2009. All patients received at least one cycle.Result:Four patients(22.2%) got complete response (CR) or very good complete response (VGPR),11 patients(61.1%) got partial response(PR), one patient (5.6%) got minute response (MR),2 patients (11.1%)were in stable condition. The overall response rate (CR+VGPR+PR) was 83.3%. Infection, anemia and renal insufficiency were improved in all patients. The drug-related side-effects included hematological toxicity 7/18 (1 patient was stage I,4 patients was stage II and 2 patients was stage III), peripheral sensory neuropathy 10/18 (3 patients was stage I,2 patients was stage,1 patients was stage III and,4 patients was stageⅣ, fatigue 4/18, infection9/18, herpes zster virus(HZV) infection 4/18, pulmonary infection 6/18, constipation 3/18, blockage of the intestine 2/18. But the all adverse reaction was relieved after drug withdrawal.Conclusion:The overall response rate of Bortezomib in combination with Dexamethasone for untreated Multiple Myeloma in our study is 80%. As the adverse effects of the regimen was mild, all patient were well tolerated.更多还原