Lü Shuqing, Wang Jianmin, Xu Xiaoqian, Ni Xiong, Huang Chongmei, Qiu Huiying, Hu Xiaoxia, Yang Jianmin
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Int J Hematol. 2009 Jan;89(1):34-38. doi: 10.1007/s12185-008-0218-9. Epub 2008 Dec 13.
The aim of the present study was to evaluate the effectiveness of bortezomib combined with epirubicin, dexamethasone, and thalidomide (BADT) for the treatment of multiple myeloma (MM). The BADT regimen consisted of a maximum of eight 4-week cycles of: intravenous bortezomib (1.0 mg/m(2)) and intravenous epirubicin (12 mg/m(2)) on days 1, 4, 8, and 11; dexamethasone (20 mg) on days 1, 2, 4, 5, 8, 9, 11, and 12; and oral thalidomide (100 mg/m(2)) on days 1-28. Twelve patients with MM were included in the study, of whom four had not been previously treated and eight had been previously treated with at least one cycle of a systemic combined regimen. All the patients completed at least two cycles of treatment, with an average of five cycles; the complete response (CR) rate was 83.3% (10/12) and stabilization of disease was 16.7% (2/12). The average number of cycles required to achieve CR was 1.9 (range 1-6). In three patients, mobilization of peripheral blood stem cells allowed a sufficient quantity of CD34+ cells to be harvested for future autotransplantation. The main adverse reactions included peripheral neuropathy (4/12), thrombocytopenia (3/12), electrocardiographic abnormalities (4/12), neutropenia (5/12), and liver function impairment (4/12), primarily grade I-II. Infection occurred in four patients with neutropenia, including one patient who developed sepsis. The estimated 1-year overall survival rate was 91.7 +/- 8.0%, and the estimated 1-year disease-free survival was 75.0 +/- 12.5%. BADT is a highly effective combined regimen, with acceptable toxicity, for the treatment of multiple myeloma.
本研究的目的是评估硼替佐米联合表柔比星、地塞米松和沙利度胺（BADT）治疗多发性骨髓瘤（MM）的有效性。BADT方案包括最多8个为期4周的周期：第1、4、8和11天静脉注射硼替佐米（1.0mg/m²）和静脉注射表柔比星（12mg/m²）；第1、2、4、5、8、9、11和12天口服地塞米松（20mg）；第1 - 28天口服沙利度胺（100mg/m²）。12例MM患者纳入本研究，其中4例既往未接受过治疗，8例既往至少接受过1个周期的全身联合治疗方案。所有患者至少完成2个周期治疗，平均为5个周期；完全缓解（CR）率为83.3%（10/12），疾病稳定率为16.7%（2/12）。达到CR所需的平均周期数为1.9（范围1 - 6）。3例患者外周血干细胞动员后收获了足够数量的CD34⁺细胞用于未来自体移植。主要不良反应包括周围神经病变（4/12）、血小板减少（3/12）、心电图异常（4/12）、中性粒细胞减少（5/12）和肝功能损害（4/12），主要为Ⅰ - Ⅱ级。4例中性粒细胞减少患者发生感染，其中1例发生脓毒症。估计1年总生存率为91.7±8.0%，估计1年无病生存率为75.0±12.5%。BADT是一种治疗多发性骨髓瘤的高效联合方案，毒性可接受。
