摘要
目的评估硼替佐米联合来那度胺及地塞米松(VRd)方案治疗多发性骨髓瘤(MM)的临床疗效和安全性。方法抽取2018年1月至2022年12月于郑州大学第五附属医院血液科和解放军联勤保障部队第九八八医院血液肿瘤科治疗的100例MM患者,按随机数字表法分为对照组和研究组,每组50例。对照组给予硼替佐米联合环磷酰胺、地塞米松(VCd)方案治疗,研究组患者给予VRd方案治疗。比较两组患者的疗效相关指标、免疫功能、肾功能、治疗有效率及不良反应发生率。结果治疗后,两组骨髓浆细胞占比、血清M蛋白及β2-微球蛋白均明显降低,且研究组低于对照组(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)的水平均显著提高,且研究组高于对照组(P<0.05);治疗后,两组血清肌酐和尿素氮水平均明显降低,且研究组低于对照组(P<0.05)。研究组患者治疗总有效率(94.00%,47/50)高于对照组(80.00%,40/50),P=0.037。两组患者用药后不良反应总发生率比较差异未见统计学意义(P=0.461)。结论VRd方案治疗MM具有较好效果和安全性,可降低骨髓浆细胞占比、血清M蛋白和β2-微球蛋白的水平,改善免疫功能及肾功能。
Objective To evaluate the efficacy and safety of bortezomib combined with lenalidomide and dexamethasone(VRd)regimen in the treatment of multiple myeloma(MM).Methods A total of 100 patients with MM from department of hematology of the Fifth Affiliated Hospital of Zhengzhou University and department of hematology oncology of No.988 Hospital of the Joint Logistic Support Force from January 2018 to December 2022 were selected,and they were divided into control group and study group according to random number table method,with 50 cases in each group.The control group received bortezomib+cyclophosphamide+dexamethasone(VCd)regimen,while the study group received VRd regimen.The efficacy related indicators,immune function,renal function,treatment effectiveness and adverse reactions were compared between the two groups.Results After treatment,the proportion of bone marrow plasma cells,serum M protein andβ2-microglobulin in the two groups significantly decreased,and the above indicators in the study group were lower than those in the control group(P<0.05).After treatment,the levels of cluster of differentiation 3^(+)(CD3^(+)),cluster of differentiation 4^(+)(CD4^(+)),CD4^(+)/cluster of differentiation 8^(+)(CD8^(+))in the two groups significantly increased,and the these indicators in the study group were higher than those in the control group(P<0.05).After treatment,the levels of serum creatinine(Scr)and blood urea nitrogen(BUN)in the two groups decreased,and the study group had lower levels than the control group(P<0.05).The total effective rate of the study group(94.00%,47/50)was higher than that of the control group(80.00%,40/50),P=0.037.There was no significant difference in the total incidence of adverse reactions between the two groups(P=0.461).Conclusions VRd regimen has good efficacy and safety in the treatment of MM,which can reduce the proportion of bone marrow plasma cells,serum M protein andβ2-microglobulin levels,and improve immune function and renal function.
作者
马若巾
张利娟
Ma Ruojin;Zhang Lijuan(Department of Hematology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《中国实用医刊》
2023年第23期86-89,共4页
Chinese Journal of Practical Medicine
