Ikeda Hiroshi, Hayashi Toshiaki, Nojima Masahiro, Yasui Hiroshi, Ikeda Yukiho, Ishida Tadao, Adachi Masaaki, Imai Kohzoh
First Department of Internal Medicine, Sapporo Medical University School of Medicine.
Rinsho Ketsueki. 2005 Apr;46(4):269-73.
We describe 2 cases of conventional therapy-resistant multiple myeloma (MM) that responded to bortezomib and dexamethasone therapy. Case 1: A 62-year-old woman with MM (IgG, kappa-type, stage IIIA) resistant to DMVM-IFN (dexamethasone, ranimustine, vincristine, melphalan, interferon-a), VAD (vincristine, doxorubicin, dexamethasone), high-dose melphalan with autologous peripheral blood stem cell transplantation (PBSCT) and thalidomide, received 2 courses of bortezomib treatment. In the first course, bortezomib alone was administered and then in the second course bortezomib was given in combination with dexamethasone. The patient's serum IgG level decreased from 8040 to 1020 mg/dl and the level of plasma cells in bone marrow was 1.2% after the treatments. Adverse reactions including rash, anemia, and thrombocytopenia occurred in the first course; however, they were milder in the second course combined with dexamethasone. Case 2: A 43-year-old man with MM (IgD, gamma-type, stage IIA) resistant to conventional and high-dose chemotherapy with PBSCT as well as thalidomide therapy, received treatment with bortezomib alone and then in combination with dexamethasone. His serum IgD level decreased from 2140 to 623 mg/dl. He suffered adverse reactions such as fatigue, anemia, and thrombocytopenia in the first course, which were relieved in the second course. These results indicate that the combination of bortezomib and dexamethasone is effective in the treatment of refractory MM and that dexamethasone can reduce the adverse reactions of bortezomib.
我们描述了2例常规治疗耐药的多发性骨髓瘤（MM）患者，他们对硼替佐米和地塞米松治疗有反应。病例1：一名62岁患有MM（IgG，κ型，IIIA期）的女性，对DMVM-IFN（地塞米松、雷尼莫司汀、长春新碱、美法仑、干扰素-α）、VAD（长春新碱、阿霉素、地塞米松）、高剂量美法仑联合自体外周血干细胞移植（PBSCT）以及沙利度胺耐药，接受了2个疗程的硼替佐米治疗。在第一个疗程中，单独给予硼替佐米，然后在第二个疗程中硼替佐米与地塞米松联合使用。治疗后患者血清IgG水平从8040降至1020mg/dl，骨髓浆细胞水平为1.2%。第一个疗程出现了包括皮疹、贫血和血小板减少在内的不良反应；然而，在第二个疗程与地塞米松联合使用时症状较轻。病例2：一名43岁患有MM（IgD，γ型，IIA期）的男性，对常规和高剂量化疗联合PBSCT以及沙利度胺治疗耐药，先接受了单独的硼替佐米治疗，然后与地塞米松联合使用。他的血清IgD水平从2140降至623mg/dl。他在第一个疗程中出现了疲劳、贫血和血小板减少等不良反应，在第二个疗程中得到缓解。这些结果表明，硼替佐米和地塞米松联合使用对难治性MM有效，并且地塞米松可以减轻硼替佐米的不良反应。
