Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo, 519-763, Republic of Korea.
Int J Hematol. 2013 Mar;97(3):382-7. doi: 10.1007/s12185-013-1270-7. Epub 2013 Jan 25.
Bortezomib is a proteasome inhibitor with potent antimyeloma activity in relapsed/refractory multiple myeloma (MM) patients. We evaluated the types and factors affecting the onset of infectious complications and mortality owing to infection in MM patients treated with bortezomib-based regimens. We reviewed 139 patients with MM treated with regimens containing bortezomib in order to assess the types and factors affecting the development of severe infections. Infections occurred in 56 (40.3 %) of 139 patients and 83 (7.8 %) cases of the 1,069 evaluable cycles. Severe infections developed in 43 (30.9 %) patients and ten patients (7.1 %) died during bortezomib-based treatment. Multivariate analysis determined lymphocytopenia grade 3-4 (OR 3.17, 95 % CI 1.38-7.31, P = 0.007) and number of cycles ≤ 8 (OR 3.91, 95 % CI 1.39-11.02, P = 0.010) as risk factors associated with increased severe infection. This study showed that MM patients who received bortezomib-based regimens are at a higher risk of severe infections within eight cycles of treatment during especially severe lymphocytopenic periods. MM patients treated with bortezomib-based regimens should be closely monitored for the development of infectious complications during lymphocytopenia.
硼替佐米是一种蛋白酶体抑制剂，对复发/难治性多发性骨髓瘤（MM）患者具有强大的抗骨髓瘤活性。我们评估了硼替佐米为基础的治疗方案治疗的 MM 患者发生感染性并发症和感染相关死亡的类型及相关影响因素。我们回顾了 139 例接受硼替佐米为基础方案治疗的 MM 患者，以评估严重感染的发生类型及相关影响因素。139 例患者中有 56 例（40.3%）发生感染，1069 个可评估周期中有 83 例（7.8%）发生感染。43 例（30.9%）患者发生严重感染，10 例（7.1%）患者在硼替佐米治疗期间死亡。多变量分析确定了 3-4 级淋巴细胞减少症（OR 3.17，95%CI 1.38-7.31，P = 0.007）和≤8 个周期（OR 3.91，95%CI 1.39-11.02，P = 0.010）为与严重感染风险增加相关的因素。这项研究表明，接受硼替佐米为基础方案治疗的 MM 患者在尤其严重的淋巴细胞减少期内，治疗的前 8 个周期内发生严重感染的风险较高。接受硼替佐米为基础方案治疗的 MM 患者在淋巴细胞减少期间应密切监测感染性并发症的发生。
