Shao Li, Wang Shasha, Meng Haitao, Qian Wenbin, Mai Wenyuan, Yu Wenjuan, Tong Hongyan, Mao Liping, Wei Juying, Qian Jiejing, Jin Jie
Department of Hematology, First Affiliated Hospital of Zhejiang University, Institute of Hematology, Key Laboratory for Hematology of Zhejiang Province, Hangzhou 310003, China.
Department of Hematology, First Affiliated Hospital of Zhejiang University, Institute of Hematology, Key Laboratory for Hematology of Zhejiang Province, Hangzhou 310003, China; Email:
Zhonghua Yi Xue Za Zhi. 2015 Oct;95(40):3297-301.
To describe the side effects of bortezomib in treatment of multiple myeloma (MM), especially the incidence of peripheral neuropathy (PN).
Information of 107 patients with MM who were treated with bortezomib in the First Affiliated Hospital of Zhejiang University from 2009 to 2014, were collected and analyzed retrospectively, to analyze the occurrence of adverse events during the treatment, especially the incidences of PN in each cycle and in different patients.
A total of 40 (37%) patients suffered from PN, among which 13 patients were grade 3 PN and no patients reported grade 4 PN. Other common treatment-related side effects were thrombocytopenia, gastrointestinal reactions, fatigue, lung infection, herpes zoster in turn. In 44 MM patients treated strictly with bortezomib 1.3 mg/m(2) (days 1, 4, 8, 11) of each 3-week cycle, 20(45%) patients suffered from PN, of which 6 (14%) patients got grade 3 PN. In other 63 patients who received bortezomib less than 1.3 mg/m(2), 20 (32%) patients got PN and 7(11%) patients were grade 3 PN. There was no significant difference in the incidence of PN between the two groups of MM patients mentioned above (P=0.149), as well as the incidence of grade 3 PN (P=0.694). Univariate and multivariate analyse revealed that gender, age, a history of hypertensive disease, diabetes or hepatitis B virus infection, baseline PN symptoms and a history of neurotoxicity drug therapy were all not risk factors for PN (all P>0.05).
The reduction of bortezomib do not decrease the incidence of PN in bortezomib treatment of MM. Age, a history of diabetes and baseline PN symptoms are not risk factors for PN in bortezomib treatment of MM.
描述硼替佐米治疗多发性骨髓瘤（MM）的副作用，尤其是周围神经病变（PN）的发生率。
收集并回顾性分析2009年至2014年在浙江大学第一附属医院接受硼替佐米治疗的107例MM患者的资料，分析治疗期间不良事件的发生情况，尤其是各周期及不同患者中PN的发生率。
共有40例（37%）患者发生PN，其中13例为3级PN，无4级PN报告。其他常见的治疗相关副作用依次为血小板减少、胃肠道反应、疲劳、肺部感染、带状疱疹。在每3周周期严格使用硼替佐米1.3mg/m²（第1、4、8、11天）治疗的44例MM患者中，20例（45%）发生PN，其中6例（14%）为3级PN。在其他接受硼替佐米剂量低于1.3mg/m²的63例患者中，20例（32%）发生PN，7例（11%）为3级PN。上述两组MM患者PN发生率（P=0.149）及3级3级PN发生率（P=0.694）差异均无统计学意义。单因素和多因素分析显示，性别、年龄、高血压病史、糖尿病或乙型肝炎病毒感染史、基线PN症状及神经毒性药物治疗史均不是PN的危险因素（均P>0.05）。
硼替佐米剂量减少并未降低硼替佐米治疗MM时PN的发生率。年龄、糖尿病史及基线PN症状不是硼替佐米治疗MM时PN的危险因素。
