Objective:To investigate the clinical efficacy and safety of ixazomib in the treatment of relapsed/refractory multiple myeloma(RRMM).Methods:The clinical data of 20 patients with RRMM admitted to the hospital from Jan...Objective:To investigate the clinical efficacy and safety of ixazomib in the treatment of relapsed/refractory multiple myeloma(RRMM).Methods:The clinical data of 20 patients with RRMM admitted to the hospital from January 2020 to January 2022 were analyzed retrospectively.All patients were treated with ixazomib-based chemotherapy regimen(IRD regimen 13 cases;ID regimen 7 cases).The objective response rate(ORR)and adverse events(AEs)were observed.Results:All 20 patients received two to seven courses of treatment,in which the median was three courses.One patient had CR,four patients had VGPR,seven patients had PR,two patients had SD,and six patients had PD.The ORR was 60.00%(12/20),and 25.00%(5/20)of them had VGPR or more.The ORR of patients with previous treatment lines≥3,ISS stage III,and high-risk cytogenetic was lower than that of patients with previous treatment lines<3,ISS stage I/II,and low-risk cytogenetics.The main AEs include anemia,thrombocytopenia,neutropenia,nausea and vomiting,diarrhea,constipation,and respiratory tract infection,most of which are grade I/II.Conclusion:Ixazomib is effective in the treatment of RRMM in some patients,and the AEs are controllable.Patients who had received less than 3 lines of treatment in the past,with ISS stage I to II and low-risk cytogenetics had better treatment effect.展开更多
目的:探讨蛋白酶体抑制剂(PI)相关血栓性微血管病(TMA)的发生规律和临床特点,为临床安全用药提供参考。方法:检索中国知网、万方数据库、维普数据库、PubMed、Web of Science等数据库中收录的PI相关TMA的案例报道,检索时间为建库至2023...目的:探讨蛋白酶体抑制剂(PI)相关血栓性微血管病(TMA)的发生规律和临床特点,为临床安全用药提供参考。方法:检索中国知网、万方数据库、维普数据库、PubMed、Web of Science等数据库中收录的PI相关TMA的案例报道,检索时间为建库至2023年4月30日。对患者基本信息、用药情况、TMA的临床表现、实验室检查、治疗及预后进行汇总分析。结果:纳入文献37篇,涉及患者92例,其中男性46例(占50.00%),女性29例(占31.52%),性别不详17例(占18.48%);平均年龄为(61±13)岁。TMA的中位发病时间为64 d,临床表现以发热、乏力、恶心/呕吐、少尿/无尿为主。因1例患者出现2次TMA,则合计93例次TMA,患者血小板计数明显降低,中位值为19.5×10^(9)/L,其中0~50×10^(9)/L的患者最多(52例次,占55.91%);64例次患者(占68.82%)的血清肌酐水平升高,其中>177~445μmol/L的患者最多(32例次,占34.41%)。停药和支持治疗后(共93例次),76例次患者(占81.72%)痊愈/好转,6例次(占6.45%)有后遗症,5例次(占5.38%)死亡。PI相关TMA中,主要涉及的药物为卡非佐米(67例次,占72.04%)。结论:应重视PI所致TMA,应用PI时应考虑患者性别、药物种类等因素;根据临床表现及实验室检查结果,尽早识别不良反应,保障患者用药安全。展开更多
目的系统评价伊沙佐米治疗多发性骨髓瘤(MM)的疗效性与安全性。方法计算机检索Web of science、PubMed、Embase、The Cochrane Library、美国临床试验注册中心数据库,检索时限为从建库至2022年6月,手工检索查询到的所有文献。按照纳入...目的系统评价伊沙佐米治疗多发性骨髓瘤(MM)的疗效性与安全性。方法计算机检索Web of science、PubMed、Embase、The Cochrane Library、美国临床试验注册中心数据库,检索时限为从建库至2022年6月,手工检索查询到的所有文献。按照纳入与排除标准选择文献、评价质量和提取数据后,采用RevMan5.4软件进行Meta分析。结果共纳入7项随机对照试验(RCT),共计3094例患者。Meta分析结果显示,伊沙佐米可降低MM患者疾病进展风险(HR=0.75,95%CI:0.68~0.83,P<0.00001),并可降低高危细胞遗传学患者疾病进展风险(HR=0.73,95%CI:0.57~0.94,P=0.01),但对患者的死亡风险无明显改善(HR=0.94,95%CI:0.82~1.08,P=0.37)。伊沙佐米组发生任何≥3级不良事件风险增加(RR=1.18,95%CI:1.11~1.25,P<0.00001),主要增加的不良事件为血小板减少、腹泻、皮疹、周围神经病变。结论伊沙佐米治疗MM对延长无进展生存期(PFS)有明显益处,可明显降低高危细胞遗传学患者的疾病进展风险,且毒性有限,口服疗法更加方便,因此是MM患者的重要治疗选择。展开更多
文摘Objective:To investigate the clinical efficacy and safety of ixazomib in the treatment of relapsed/refractory multiple myeloma(RRMM).Methods:The clinical data of 20 patients with RRMM admitted to the hospital from January 2020 to January 2022 were analyzed retrospectively.All patients were treated with ixazomib-based chemotherapy regimen(IRD regimen 13 cases;ID regimen 7 cases).The objective response rate(ORR)and adverse events(AEs)were observed.Results:All 20 patients received two to seven courses of treatment,in which the median was three courses.One patient had CR,four patients had VGPR,seven patients had PR,two patients had SD,and six patients had PD.The ORR was 60.00%(12/20),and 25.00%(5/20)of them had VGPR or more.The ORR of patients with previous treatment lines≥3,ISS stage III,and high-risk cytogenetic was lower than that of patients with previous treatment lines<3,ISS stage I/II,and low-risk cytogenetics.The main AEs include anemia,thrombocytopenia,neutropenia,nausea and vomiting,diarrhea,constipation,and respiratory tract infection,most of which are grade I/II.Conclusion:Ixazomib is effective in the treatment of RRMM in some patients,and the AEs are controllable.Patients who had received less than 3 lines of treatment in the past,with ISS stage I to II and low-risk cytogenetics had better treatment effect.
文摘目的:探讨蛋白酶体抑制剂(PI)相关血栓性微血管病(TMA)的发生规律和临床特点,为临床安全用药提供参考。方法:检索中国知网、万方数据库、维普数据库、PubMed、Web of Science等数据库中收录的PI相关TMA的案例报道,检索时间为建库至2023年4月30日。对患者基本信息、用药情况、TMA的临床表现、实验室检查、治疗及预后进行汇总分析。结果:纳入文献37篇,涉及患者92例,其中男性46例(占50.00%),女性29例(占31.52%),性别不详17例(占18.48%);平均年龄为(61±13)岁。TMA的中位发病时间为64 d,临床表现以发热、乏力、恶心/呕吐、少尿/无尿为主。因1例患者出现2次TMA,则合计93例次TMA,患者血小板计数明显降低,中位值为19.5×10^(9)/L,其中0~50×10^(9)/L的患者最多(52例次,占55.91%);64例次患者(占68.82%)的血清肌酐水平升高,其中>177~445μmol/L的患者最多(32例次,占34.41%)。停药和支持治疗后(共93例次),76例次患者(占81.72%)痊愈/好转,6例次(占6.45%)有后遗症,5例次(占5.38%)死亡。PI相关TMA中,主要涉及的药物为卡非佐米(67例次,占72.04%)。结论:应重视PI所致TMA,应用PI时应考虑患者性别、药物种类等因素;根据临床表现及实验室检查结果,尽早识别不良反应,保障患者用药安全。
文摘目的系统评价伊沙佐米治疗多发性骨髓瘤(MM)的疗效性与安全性。方法计算机检索Web of science、PubMed、Embase、The Cochrane Library、美国临床试验注册中心数据库,检索时限为从建库至2022年6月,手工检索查询到的所有文献。按照纳入与排除标准选择文献、评价质量和提取数据后,采用RevMan5.4软件进行Meta分析。结果共纳入7项随机对照试验(RCT),共计3094例患者。Meta分析结果显示,伊沙佐米可降低MM患者疾病进展风险(HR=0.75,95%CI:0.68~0.83,P<0.00001),并可降低高危细胞遗传学患者疾病进展风险(HR=0.73,95%CI:0.57~0.94,P=0.01),但对患者的死亡风险无明显改善(HR=0.94,95%CI:0.82~1.08,P=0.37)。伊沙佐米组发生任何≥3级不良事件风险增加(RR=1.18,95%CI:1.11~1.25,P<0.00001),主要增加的不良事件为血小板减少、腹泻、皮疹、周围神经病变。结论伊沙佐米治疗MM对延长无进展生存期(PFS)有明显益处,可明显降低高危细胞遗传学患者的疾病进展风险,且毒性有限,口服疗法更加方便,因此是MM患者的重要治疗选择。
