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目的观察硼替佐米联合地塞米松治疗多发性骨髓瘤(MM)的疗效和不良反应。方法2005年6月至2007年7月收集温州医学院附属第一医院14例MM患者,其中男11例,女3例;年龄52~77岁,平均年龄为65.1岁。第1,4,8和11天给予静脉推注硼替佐米1.3mg/m2;第1~4天,8~11天给予地塞米松20~40mg静脉滴注,每例患者接受1~8个疗程的治疗。采用欧洲骨髓移植协作组(EBMT)标准观察疗效,并按美国国立癌症研究所(NCI)(第3版)CTCAE标准判断不良反应。结果中位随访时间为3.5(1.3~10)个月,12例(86%)患者对治疗有效,其中2例完全缓解,6例患者接近完全缓解,3例部分缓解,1例轻微反应;2例进展。14例患者中10例出现不同程度的乏力,7例出现周围神经病变,腓肠肌酸痛2例,4例出现胃肠道症状,5例血小板减少,1例播散型带状疱疹,1例顽固性低钠血症。均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。
Objective To observe the efficacy and adverse reactions of bortezomib and dexamethasone in the treatment of multiple myeloma (MM). Methods From June 2005 to July 2007, 14 MM patients were collected from the First Affiliated Hospital of Wenzhou Medical College, including 11 males and 3 females, aged 52-77 years with a mean age of 65.1 years. Intravenous injection of bortezomib 1.3 mg / m2 on days 1, 4, 8 and 11; intravenous drip of dexamethasone 20 to 40 mg on day 1 to day 4 and on days 8 to 11, with each patient receiving from 1 to 8 Treatment of treatment. Efficacy was assessed using the European Association for Bone Marrow Transplantation (EBMT) criteria and the adverse effects were assessed by the CTCAE criteria of the National Cancer Institute (NCI) (3rd edition). Results The median follow-up time was 3.5 months (1.3-10 months). Twelve patients (86%) were effective in the treatment. Two patients were completely relieved, six patients were almost completely relieved, three patients partially relieved, and one patient slightly reactive. Example progress. Fourteen patients had varying degrees of fatigue, 10 had peripheral neuropathy, 2 had gastrocnemuscular pain, 4 had gastrointestinal symptoms, 5 had thrombocytopenia, 1 had disseminated shingles, and 1 had intractable Hyponatremia. Almost symptomatic treatment were relieved. Conclusion Bortezomib combined with dexamethasone is a new and effective treatment for MM. The adverse reactions are slightly more, but can be improved after symptomatic treatment and dose adjustment.