CAJ | 학술논문

目的探讨硼替佐米再治疗多发性骨髓瘤(MM)的疗效及安全性.方法回顾性分析2006年5月至2011年8月收治的76例硼替佐米初次治疗疗效达部分反应(PR)以上,复发或疾病进展后予以硼替佐米再治疗的MM患者,评价硼替佐米再治疗的疗效及不良反应.结果硼替佐米再治疗MM的总有效率(ORR)为60.5％,其中完全反应(CR)率6.5％,非常好的部分反应(VGPR)率15.8％,PR率38.2％.按硼替佐米初治后疗效分为CR、VGPR、PR组,3组患者再治疗后ORR分别为84.6％、73.1％和43.2％.按患者硼替佐米再治疗后疗效分成2组,达到PR及以上的为有效组,未达到PR的为无效组,两组自硼替佐米再治疗后中位疾病无进展生存期分别为7(1～39)个月和5(1 ～14)个月(P＞0.05)；中位总生存期分别为16(2 ～64)个月和8(1～28)个月(P＜0.05).88.2％的患者硼替佐米再治疗时出现不同程度的不良反应,其中仅9.2％(7例)患者为Ⅲ～Ⅳ级,主要为中性粒细胞减少、腹泻和血小板减少,仅1例发生严重的周围神经病变.结论硼替佐米初治疗效好的MM患者,再予以硼替佐米治疗反应率高,不良反应发生率较前无明显增加.
목적 탐토붕체좌미재치료다발성골수류(MM)적료효급안전성.방법 회고성분석2006년5월지2011년8월수치적76례붕체좌미초차치료료효체부분반응(PR)이상,복발혹질병진전후여이붕체좌미재치료적MM환자,평개붕체좌미재치료적료효급불량반응.결과 붕체좌미재치료MM적총유효솔(ORR)위60.5％,기중완전반응(CR)솔6.5％,비상호적부분반응(VGPR)솔15.8％,PR솔38.2％.안붕체좌미초치후료효분위CR、VGPR、PR조,3조환자재치료후ORR분별위84.6％、73.1％화43.2％.안환자붕체좌미재치료후료효분성2조,체도PR급이상적위유효조,미체도PR적위무효조,량조자붕체좌미재치료후중위질병무진전생존기분별위7(1～39)개월화5(1 ～14)개월(P＞0.05)；중위총생존기분별위16(2 ～64)개월화8(1～28)개월(P＜0.05).88.2％적환자붕체좌미재치료시출현불동정도적불량반응,기중부9.2％(7례)환자위Ⅲ～Ⅳ급,주요위중성립세포감소、복사화혈소판감소,부1례발생엄중적주위신경병변.결론 붕체좌미초치료효호적MM환자,재여이붕체좌미치료반응솔고,불량반응발생솔교전무명현증가.
Objective To evaluate the efficacy and safety of bortezomib retreatment in 76 patients with relapsed/refractory multiple myeloma (MM),who previously responded to bortezomib.Methods Retrospective analysis of 76 MM patients,who had achieved at least a partial response (PR) on initial bortezomib therapy in our hospital from May 2006 to August 2011,received bortezomib retreatment when they relapsed or progressed.Results The overall response rate (ORR) was 60.5％,among them 6.5％ patients achieved CR,5.8％ patients achieved very good partial response (VGPR),38.2％ patients achieved PR.Then we further stratified all patients into 3 groups according to the response of initial bortezomib therapy,including CR group,VGPR group and PR group.After bortezomib retreatment,the ORR of the 3 groups was 84.6％,73.1％ and 43.2％,respectively.According to the response of bortezomib retreatment,the patients were divided into 2 groups:group 1 who at least achieved PR,group 2 who showed no response.The median progression-free survival (PFS) after bortezomib retreatment for group 1 and 2 was 7(1-39) and 5(1-14)months,respectively (P ＞ 0.05),while the median overall survival (OS) after bortezomib retreatment was 16 (2-64) and 8 (1-28) months,respectively (P ＜ 0.05).Adverse events (AE) were identified in 88％patients during bortezomib retreatment,including neutropenia,diarrhea and thrombocytopenia,only 9.2％ (7patients) reached Ⅲ-Ⅳ grade of AE.Severe peripheral neuropathy occurred in only one patient.Conclusion Bortezomib retreatment regimen is demonstrated a higher response rate in patients who achieved deeper response in initial treatment,with no more adverse events.