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目的研究蛋白酶体抑制剂硼替佐米(万珂,Velcade,V)为主的化疗方案治疗多发性骨髓瘤(MM)的疗效和不良反应。方法MM患者接受万珂为主的联合方案进行化疗。疗效评定按照EBMT/ABMT标准。结果可评估疗效者12例,初治8例,复发难治4例。治疗总体反应率100%(12/12),其中,完全缓解(CR)5例(41.7%),接近完全缓解(nCR)2例(16.7%),部分缓解(PR)5例(41.7%)。初治患者达到最佳反应所需疗程中位数为2个(2~3个),复发难治患者达到最佳反应所需疗程中位数为4个(3~5个)。中位随访11月(4~27月),所有患者均存活。不良反应多为1~2级,包括周围神经病变(41.7%)、血小板减少(33.3%)、恶心呕吐(33.3%)及呼吸道感染(16.7%),经对症处理后好转。结论万珂为主的化疗方案治疗初治和复发难治MM病例,起效较快,反应率和完全缓解率较高,不良反应轻,患者耐受好,值得推广。
Objective To investigate the efficacy and adverse reactions of the chemotherapy regimen based on the proteasome inhibitor bortezomib (Velcade, V) in the treatment of multiple myeloma (MM). Methods MM patients underwent co-treatment with Velcade-based chemotherapy. Efficacy evaluation in accordance with EBMT / ABMT standards. The results can be evaluated in 12 cases of efficacy, initial treatment in 8 cases, 4 cases of recurrence and refractory. The overall response rate was 100% (12/12), including 5 cases (41.7%) of complete remission (CR), 2 cases of complete remission (nCR), 16 cases of complete remission (PR) . The median treatment course required for optimal response was 2 (2 to 3) in patients with newly diagnosed disease, and 4 (3 to 5) were needed to achieve optimal response in patients with relapsed disease. The median follow-up in November (4 to 27 months), all patients were alive. Adverse reactions were mostly grade 1 to 2, including peripheral neuropathy (41.7%), thrombocytopenia (33.3%), nausea and vomiting (33.3%) and respiratory tract infection (16.7%), after symptomatic treatment improved. Conclusion Vanke-based chemotherapy regimen for the treatment of naive and relapsed refractory MM cases, rapid onset, high response rate and complete remission rate, mild adverse reactions, patients with good tolerance, it is worth promoting.