Malani Ashok Kumar, Gupta Vicram, Rangineni Raj
Hematology and Medical Oncology, Heartland Regional Medical Center, St. Joseph, MO, USA.
Acta Haematol. 2006;116(4):255-8. doi: 10.1159/000095876.
Multiple myeloma (MM) associated with renal failure carries a worse prognosis when compared with MM without renal failure. Bortezomib, a reversible proteosome inhibitor, is a new drug indicated for the treatment of refractory or relapsed myeloma. Published data on the use of bortezomib in patients with myeloma and renal failure are few. We report our experience with bortezomib and dexamethasone in 3 previously untreated and 1 relapsed patient with MM and renal failure. All patients achieved rapid improvement in their renal function as measured by serum creatinine levels with only 1-2 cycles of bortezomib (+/- dexamethasone), 3 of 4 patients had a near complete response and 1 patient had a partial response. The rapid reversal of renal dysfunction with bortezomib (+/- dexamethasone) treatment may be an effective strategy to prevent end stage renal failure in MM, thereby improving the morbidity and mortality in this otherwise poor prognosis subset of patients with myeloma.
与无肾衰竭的多发性骨髓瘤（MM）相比，合并肾衰竭的MM预后更差。硼替佐米，一种可逆的蛋白酶体抑制剂，是一种用于治疗难治性或复发性骨髓瘤的新药。关于硼替佐米在骨髓瘤合并肾衰竭患者中应用的已发表数据很少。我们报告了硼替佐米联合地塞米松治疗3例初治和1例复发的MM合并肾衰竭患者的经验。所有患者仅接受1 - 2个周期的硼替佐米（±地塞米松）治疗后，血清肌酐水平测定显示肾功能迅速改善，4例患者中有3例接近完全缓解，1例患者部分缓解。硼替佐米（±地塞米松）治疗使肾功能障碍迅速逆转，这可能是预防MM患者终末期肾衰竭的有效策略，从而改善这一预后较差的骨髓瘤患者亚组的发病率和死亡率。
