Takatoku Masaaki, Noborio-Hatano Kaoru, Takahashi Satoko, Kikuchi Satoru, Mori Masaki, Muroi Kazuo, Komatsu Norio, Ozawa Keiya
Rinsho Ketsueki. 2004 Feb;45(2):144-8.
A proteasome inhibitor with a new molecular target (PS-341: bortezomib) was recently developed, and its efficacy in the treatment of refractory multiple myeloma has been reported in the United States. Here, we present a 54-year-old Japanese male patient with refractory multiple myeloma resistant to thalidomide. In 1998, the patient was diagnosed as having multiple myeloma (IgG-kappa) and underwent chemotherapy, autologous hematopoietic cell transplantation and interferon therapy, but the disease recurred. In December 2002, thalidomide and high-dose dexamethasone therapy was initiated, and while this combination therapy was effective at first, the multiple myeloma became unresponsive. On 23 June 2003, bortezomib therapy with the following regime was therefore started: 2.2 mg (1.3 mg/m2) of bortezomib was injected intravenously on days 1, 4, 8 and 11, and after a one-week break, another cycle was performed. Starting on day 8 of the administration, the serum total protein, IgG, serum calcium and LDH levels decreased rapidly, and after day 45 of the administration, blood transfusion was no longer needed. Since this is the first report of the use of bortezomib in the treatment of refractory multiple myeloma in Japan, further monitoring of this patient will provide extremely valuable information for developing a therapy against this disease.
一种具有新分子靶点的蛋白酶体抑制剂（PS - 341：硼替佐米）最近研制成功，其在美国治疗难治性多发性骨髓瘤的疗效已有报道。在此，我们报告一名54岁对沙利度胺耐药的难治性多发性骨髓瘤日本男性患者。1998年，该患者被诊断为多发性骨髓瘤（IgG - κ型），并接受了化疗、自体造血细胞移植和干扰素治疗，但疾病复发。2002年12月开始使用沙利度胺和大剂量地塞米松治疗，虽然这种联合治疗起初有效，但多发性骨髓瘤后来变得无反应。因此，2003年6月23日开始采用以下方案进行硼替佐米治疗：在第1、4、8和11天静脉注射2.2毫克（1.3毫克/平方米）硼替佐米，休息一周后进行下一个周期。从给药第8天开始，血清总蛋白、IgG、血清钙和乳酸脱氢酶水平迅速下降，给药第45天后不再需要输血。由于这是日本关于硼替佐米用于治疗难治性多发性骨髓瘤的首例报告，对该患者的进一步监测将为开发针对这种疾病的治疗方法提供极有价值的信息。
