邓书会, 徐燕, 隋伟薇, 邹德慧, 安刚, 邱录贵. 硼替佐米 环磷酰胺和地塞米松联合诱导治疗初诊多发性骨髓瘤患者131例的临床研究[J]. 中国肿瘤临床, 2022, 49(20): 1067-1072. DOI: 10.12354/j.issn.1000-8179.2022.20220046
引用本文: 邓书会, 徐燕, 隋伟薇, 邹德慧, 安刚, 邱录贵. 硼替佐米 环磷酰胺和地塞米松联合诱导治疗初诊多发性骨髓瘤患者131例的临床研究[J]. 中国肿瘤临床, 2022, 49(20): 1067-1072. DOI: 10.12354/j.issn.1000-8179.2022.20220046
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Shuhui Deng, Yan Xu, Weiwei Sui, Dehui Zou, Gang An, Lugui Qiu. Clinical study of bortezomib combined with cyclophosphamide and dexamethasone as an induction regimen for patients with newly diagnosed multiple myeloma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(20): 1067-1072. DOI: 10.12354/j.issn.1000-8179.2022.20220046
Citation: Shuhui Deng, Yan Xu, Weiwei Sui, Dehui Zou, Gang An, Lugui Qiu. Clinical study of bortezomib combined with cyclophosphamide and dexamethasone as an induction regimen for patients with newly diagnosed multiple myeloma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(20): 1067-1072. DOI: 10.12354/j.issn.1000-8179.2022.20220046
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硼替佐米 环磷酰胺和地塞米松联合诱导治疗初诊多发性骨髓瘤患者131例的临床研究

Clinical study of bortezomib combined with cyclophosphamide and dexamethasone as an induction regimen for patients with newly diagnosed multiple myeloma

    摘要
  • 摘要:
      目的  探讨硼替佐米（bortezomib，Vel）联合环磷酰胺（cyclophosphamide，CTX）的三药方案BCD（Vel、CTX、地塞米松）作为初诊多发性骨髓瘤（multiple myeloma，MM）患者诱导治疗的临床效能及安全性。
      方法  回顾性分析2008年4月至2017年8月中国医学科学院血液病医院队列研究的131例初诊MM患者的临床资料。
      结果  患者中位年龄为58岁。年龄≤65岁的患者中27.3%（24/88）进行了自体造血干细胞移植。患者总缓解率（overall response rate，ORR）为88.5%。总体中位无进展生存时间（median progression-free survival，mPFS）为36.0个月，中位总生存时间（median overall survival，mOS）为63.0个月。IgH/FGFR3易位对患者的ORR及生存期未见明显不良影响。非血液学毒性方面最常见的依次为感染、周围神经炎（peripheral neuritis，PN）等。血液学毒性方面，CTCAE 3～4级中性粒细胞减少发生率为25.4%，3/4级血小板减少发生率为27.2%。
      结论  以BCD作为诱导治疗，可使80%以上的初诊MM患者获得缓解。在此治疗基础上，IgH/FGFR3易位对患者的疗效及生存未见明显不良影响。低剂量、分次应用环磷酰胺的方法安全性更优。

     

    Abstract:
      Objective  To investigate the clinical efficacy and safety of bortezomib, cyclophosphamide, and dexamethasone (BCD) for the treatment of newly diagnosed multiple myeloma (MM).
      Methods  We retrospectively analyzed 131 patients from April 2008 to August 2017, who were newly diagnosed MM and had enrolled in Institute of Hematology & Blood Diseases Hospital.
      Results  The median age of the patients was 58 years, and 27.3% patients (24/88) aged ≤65 years underwent autologous hematopoietic stem cell transplantation. The overall response rate (ORR) was 88.5%, the median progression-free survival (PFS) was 36.0 months, and the median overall survival (mOS) was 63.0 months. IgH/FGFR3 translocation showed no adverse effects on the ORR or survival (PFS or OS). The most common non-hematological toxicities were infection, peripheral neuritis (PN), and gastrointestinal events. Of the observed hematological toxicities, Common Terminology Criteria for Adverse Events (CTCAE) grade 3/4 neutropenia occurred in 25.4% of patients and CTCAE grade 3/4 thrombocytopenia occurred in 27.2% of patients.
      Conclusions  BCD, as induction therapy, achieved remission in more than 80% of patients with newly diagnosed MM. IgH/FGFR3 translocation showed no adverse effects on treatment efficacy or patient survival. Based on the results of previous studies, low dose fractional application of cyclophosphamide is markedly safer than BCD.

     

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