【作者】 叶海格； 俞康； 邢冲云； 梁彬； 钱红兰； 马泳泳； 毕来喜； 罗盛； 任行洲； 胡永仙； 孙岚； 胡旭东； 陈怡； 张君丽； 沈志坚；

【Author】 YE Haige YU Kang XING Congyun LIANG Bin QIAN Honglan MA Yongyong BI Laixi LUO Sheng REN Xingzhou HU Yongxian SHUN Lan HU Xudong JIANG Songfu ZHANG Junli SHEN Zijian

【机构】 温州医学院附属第一医院血液科；

【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)患者的疗效和不良反应。方法:10例 MM 患者,男性7例,女性3例,平均年龄64.3(52～77)岁。在为期约3周的疗程内给予硼替佐米1.3mg/m~2,第1,4,8和11天。第1～4天,8～11天给予地塞米松针20～40mg 静脉滴注。每例患者接受1～7个疗程的治疗。采用 EBMT 标准观察疗效,并按 NCI CTCAE(第3版)标准判断不良反应。结果:中位随访6(2～9)个月,8例患者(80%)对治疗有效,其中5例患者接近完全缓解,2例部分缓解,1例轻微反应,2例进展。最常见的不良反应为乏力,10例患者中9例出现不同程度的乏力,6例出现周围神经病变,腓肠肌酸痛2例,3例出现胃肠道症状,3例腹泻较剧烈,1例腹泻与便秘交替,3例血小板减少,播数型带状疱疹1例,顽固的低钠血症1例。经对症治疗基本缓解。结论:硼替佐米联合地塞米松是治疗 MM 的新的有效治疗方法,不良反应稍多,但经对症治疗及调整用药剂量后均能改善。更多还原

【Abstract】 Objective:To investigate the efficacy and toxicity of bortezomib in combination with dexamethasone for the treatment of patients with multiple myeloma(MM).Method:Ten patients(7 males, 3 females,mean age 64.3 yrs)with MM were treated with bortezomib(1.3mg/m2)by intravenous bolus twice a week for 2 weeks in a 21-day cycle,followed by an intravenous injection of dexamethasone 20～40mg.The patients had received one to seven courses at least.Response to bortezomib was evaluated according to the criteria of the European Group for Blood and Marrow Transplantation(EBMT)before initiation of each bortezomib chemotherapy course.Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0.Result:The median follow-up duration from the begining of bortezomib treatment was 6 months.Clinical reponse was observed in 8 patients(80%), including near complete response in 5,partial response in 2,minimal response in 1 and progressive disease in 2.The most common adverse events were fatigue(9 patients),peripheral neuropathy(6 patients), gastrocnemius myalgia(2 patients),gastrointestinal symptoms(3 patients,severe diarrhea in 3 patients, diarrhea alternated with constipation in 1 patients),thrombocytopenia(3 patients),disseminated herpes zoster(1 patient)and refractory byponatremia(1 patient).The adverse events were subsided on routine supportive care.Conclusion:Bortezomib in combination with dexamethasone is an effective therapy with a high response rate in MM patients.All the adverse events were more than common but were manageable with symptomatic therapy and(or)dose modification.更多还原