Department of Hematology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China.
Hematology. 2023 Dec;28(1):2210907. doi: 10.1080/16078454.2023.2210907.
To research the effects of autonomic neuropathy of the digestive system induced by bortezomib on clinical efficacy and quality of life.
A total of 150 patients with newly diagnosed multiple myeloma (MM) were hospitalized in our department from January 2018 to December 2021, and treated with bortezomib-based combination regimens. To observe the incidence of autonomic neuropathy of the digestive system and analyse the correlations between the severity of autonomic neuropathy and the efficacy, survival, age, underlying diseases and personal history.
The incidence of autonomic neuropathy of the digestive system was 60.0%. The overall response rate (ORR), 2-year progression-free survival (PFS) rate and 2-year overall survival (OS) rate in the grade 3 group of autonomic neuropathy were significantly lower than those in the grade 1-2 group, and the differences were statistically significant ( < 0.05). Age, constipation, diabetes, fracture/spinal cord compression in bed and history of alcoholism were positively correlated with the risk of autonomic neuropathy of the digestive system ( < 0.05). The autonomic neuropathy of the digestive system was significantly alleviated in most patients after the timely adjustment of the treatment regimen, and bortezomib could continue to be administered.
The incidence of autonomic neuropathy of the digestive system induced by bortezomib is high, and its severity is closely related to efficacy, advanced age, constipation, diabetes, fracture/spinal cord compression in bed and history of alcoholism. Early detection and early treatment are necessary to better treat the disease and reverse the autonomic neuropathy.
研究硼替佐米引起的消化系统自主神经病变对临床疗效和生活质量的影响。
选取 2018 年 1 月至 2021 年 12 月我院收治的 150 例初治多发性骨髓瘤（MM）患者，采用硼替佐米为基础的联合方案进行治疗。观察消化系统自主神经病变的发生率，并分析自主神经病变严重程度与疗效、生存、年龄、基础疾病和个人史的相关性。
消化系统自主神经病变的发生率为 60.0%。3 级自主神经病变组的总缓解率（ORR）、2 年无进展生存率（PFS）和 2 年总生存率（OS）均显著低于 1-2 级组，差异有统计学意义（ < 0.05）。年龄、便秘、糖尿病、卧床骨折/脊髓压迫和酒精中毒史与消化系统自主神经病变的风险呈正相关（ < 0.05）。大多数患者在及时调整治疗方案后，消化系统自主神经病变得到明显缓解，可继续使用硼替佐米。
硼替佐米引起的消化系统自主神经病变发生率较高，其严重程度与疗效、年龄较大、便秘、糖尿病、卧床骨折/脊髓压迫和酒精中毒史密切相关。早期发现和早期治疗对于更好地治疗疾病和逆转自主神经病变非常必要。
