减低剂量的硼替佐米治疗老年性多发性骨髓瘤临床研究
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首都医学发展科研基金(2009-3072).


Reduced-dose of bortezomib for treatment of elderly patients with multiple myeloma: a clinical study
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Supported by Capital Science Foundation for Medical Development (2009-3072).

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    摘要:

    目的 回顾分析1.0 mg/m2和0.7 mg/m2两种低剂量硼替佐米治疗老年(≥60岁)多发性骨髓瘤患者的疗效和相关毒副反应,探讨硼替佐米在老年患者治疗上的剂量选择。方法 2006年6月至2012年1月在军事医学科学院附属医院血液科接受低于标准剂量的硼替佐米治疗的老年多发性骨髓瘤患者共26例,其中16例接受1.0 mg/m2剂量治疗,10例接受0.7 mg/m2剂量治疗。观察疗效和相关毒副反应。结果 第1个疗程结束后1.0 mg/m2组和0.7 mg/m2组有效的例数分别为13例和8例,第2个疗程结束后仍有效的例数分别为9例和5例,两组间差异无统计学意义(P>0.05)。硼替佐米的主要不良反应为消化道症状、周围神经病变、血小板减少和感染等,两组间的发生率差异均无统计学意义(P>0.05)。结论 老年多发性骨髓瘤患者采用1.0 mg/m2和0.7 mg/m2硼替佐米治疗剂量均相对安全有效;对于不能耐受1.0 mg/m2者,也可选择0.7 mg/m2剂量。

    Abstract:

    ObjectiveTo discuss the appropriate dose of bortezomib for treatment of elderly patients with multiple myeloma (MM) by evaluating the curative effects and toxicity of two different doses of bortezomib (1.0 mg/m2 and 0.7 mg/m2). MethodsTwenty-six MM patients aged ≥60 years old received reduced-dose of bortezomib from June 2006 to January 2012, with 16 receiving a dose of 1.0 mg/m2 and the other 10 receiving a dose of 0.7 mg/m2 .The curative effects and the adverse events were observed. ResultsAfter the first course of treatment 13 patients responsed in the 1.0 mg/m2 group and 8 in the 0.7 mg/m2 group. After the second course of treatment 9 patients still responsed in the 1.0 mg/m2 group and 5 in the 0.7 mg/m2 group, with no significant difference found between the two groups (P>0.05). The main adverse effects of bortezomib treatment included digestive symptoms, peripheral neuropathy, thrombocytopenia and infection, with no significant difference found between the two groups (P>0.05). Conclusion Bortezomib-based regimens at 1.0 mg/m2 and 0.7 mg/m2 are safe and effective for elderly MM patients; if the dose 1.0 mg/m2 can not be tolerated, 0.7 mg/m2 can be chosen.

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  • 收稿日期:2012-02-12
  • 最后修改日期:2012-04-17
  • 录用日期:2012-09-29
  • 在线发布日期: 2012-10-24
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