| 硼替佐米为基础的治疗方案治疗华氏巨球蛋白血症15例的临床分析 |
| 投稿时间：2016-05-18 修订日期：2016-07-18 点此下载全文 |
| 引用本文：侯楠,安然,侯健.硼替佐米为基础的治疗方案治疗华氏巨球蛋白血症15例的临床分析[J].药学实践杂志,2016,34(5):459~462 |
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| 中文摘要:目的 探讨以硼替佐米为基础的方案治疗华氏巨球蛋白血症（Waldenström macroglobulinemia，WM）的临床疗效及安全性。方法 回顾性分析2008年12月至2015年10月收治的15例采用以硼替佐米为基础方案治疗的WM患者的临床资料。其中1例采用硼替佐米+地塞米松（BD）方案，3例采用硼替佐米+地塞米松+美罗华（RBD）方案，11例采用硼替佐米+地塞米松+环磷酰胺（BCD）方案，评价上述三方案的疗效及不良反应，并进行生存分析。结果 治疗的总反应率及主要反应率分别为93.3%和80%[其中完全缓解（CR）1例、非常好的部分缓解（VGPR）2例、部分缓解（PR）9例、微小反应（MR）2例]。不良反应包括胃肠道副作用（53.3%）、白细胞减少（20%）、感染（20%）及外周神经病变（26.7%）。随访时间为3~85个月（中位数21个月），无进展生存（PFS）时间为3~36个月（中位数21个月），1年的PFS率分别为83.3%。生存分析显示IPSSWM分级为高危组（P=0.015）及用药后治疗反应小于PR（P=0.024）是影响WM患者PFS的危险因素。结论 以硼替佐米为基础的治疗方案可有效治疗WM患者，IPSSWM分级体系及治疗反应可作为判断以硼替佐米为基础的治疗方案的WM患者疾病进展预后的参考因素。 |
| 中文关键词:硼替佐米 华氏巨球蛋白血症 疗效分析 |
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| Clinical analysis of 15 patients with Waldenström macroglobulinemia received bortezomib-based treatment |
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| Abstract:Objective To summarize the clinical experience of bortezomib-based treatment for Waldenström macroglobulinemia and evaluate the therapeutic efficacy and safety. Methods The clinical data were collected for 15 patients with Waldenström macroglobulinemia receiving bortezomib-based treatment from December 2008 to October 2015.Three therapeutic regimens included BD (bortezomib and dexamethasone) in one case, RBD (bortezomib, rituximab and dexamethasone) in three cases and BCD (bortezomib, dexamethasone and cyclophosphamide) in eleven cases.Responses, adverse reactions and survival analysis were evaluated respectively. Results The overall response rate and major response rate were 93.3% and 80% including CR 1 case, VGPR 2 cases, PR 9 cases and MR 2 cases. The common adverse events included gastrointestinal (53.3%), leukopenia (20%), infection (20%) and peripheral neuropathy (26.7%). After a median follow-up of 21 (3-85) months, the median PFS (progression-free survival) time was 21 (3-36) months and 1 year PFS rate was 83.3%. Survival analysis showed that two prognostic risk factors related to PFS were high-risk group based on international prognostic scoring system for WM(IPSSWM)(P=0.015) and the low response to treatment (P=0.024). Conclusion Bortezomib-based therapeutic regimensexhibited significant efficacyfor patients with WM. IPSSWM and the responses to treatment can be usedto monitor the disease progression and evaluate the therapeutic result. |
| keywords:bortezomib Waldenström macroglobulinemia survival analysis |
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