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目的观察硼替佐米联合地塞米松(PD)方案治疗初治多发性骨髓瘤(MM)的疗效和不良反应。方法 2009年9月至2011年12月收集安康市中心医院MM患者16例,均给予PD方案为一线治疗:硼替佐米1.3mg/m2,静脉注射,第l、4、8、1l天;地塞米松20mg/d,静脉滴注,第1～4,8～11天。每3周为1个周期,所有患者至少接受1个疗程的治疗。采用国际骨髓瘤工作组(IMWG)标准观察疗效和不良反应。结果患者接受1～6个疗程的治疗后,总有效率为94%,其中完全缓解(CR)9例(56%),非常好的部分缓解(VGPR)1例(6%),部分缓解(PR)3例(19%),轻微反应(MR)2例(13%),疾病稳定(SD)1例(6%)。可见初始疗效的中位时间为3(1～5)周。最常见的不良反应为胃肠道症状,其中便秘6例(38%),恶心、呕吐3例(19%);其次为血液学改变,血小板减少5例(31%);另外,周围神经病变6例(38%),乏力3例(19%);给予对症处理后均好转。结论 PD方案治疗初治MM患者疗效明确,不良反应较轻且大多可逆,具有较好的耐受性。
Objective To observe the efficacy and adverse reactions of bortezomib combined with dexamethasone (PD) in the treatment of newly diagnosed multiple myeloma (MM). Methods From September 2009 to December 2011, 16 patients with MM were collected from Ankang Central Hospital. All PD patients were given first-line treatment: bortezomib 1.3 mg / m2, iv, iv, 4, 8, Dexamethasone 20mg / d, intravenous drip, the 1st ~ 4, 8 ~ 11 days. Every 3 weeks for a cycle, all patients receive at least 1 course of treatment. The efficacy and adverse reactions were observed using the International Myeloma Working Group (IMWG) standard. Results After receiving 1 to 6 courses of treatment, the total effective rate was 94% in 9 patients (56%) with complete remission (CR), 1 patient (6%) with very good partial response (VGPR) and partial response PR (3 cases, 19%), mild reaction (MR), 13 cases (13%) and stable disease (SD), 1 case (6%). Visible initial effect of the median time of 3 (1 ~ 5) weeks. The most common adverse reactions were gastrointestinal symptoms, including constipation in 6 cases (38%), nausea and vomiting in 3 cases (19%), hematologic changes followed by thrombocytopenia in 5 cases (31%), and peripheral neuropathy 6 cases (38%), fatigue in 3 cases (19%); given symptomatic treatment were improved. Conclusion The PD regimen is effective in treating untreated MM patients with mild side effects and most of them are reversible with good tolerability.