Clinical Observation Of Curcumin Combined With BD Regimenin The Treatment For Multiple Myeloma(MM).

Backgrounds and Objections Multiple myeloma is the second most common malignant tumor in blood system. At present chemotherapy is the main method for the treatment of multiple myeloma in our country,the application of new drugs had greatly improved the curative effect of multiple myeloma,but some patients are still not sensitive for new drugs.So we need to explore new more effective regimens for the treatment to improve the therapeutic efficacy and gain greater benefits for patients with myeloma. Curcumin is a plant polyphenol extracted from curcuma genus roots,which has many pharmacological effects,such as anti-tumor, anti-inflammatory,antioxid ant,antibacterial and so on.The curcumin has been applied in a variety of solid tumor(such as liver cancer, lung cancer, oral squamous cell carcinoma, esoph ageal cancer etc),and its application research in multiple myeloma is increasin g day by day.Some literature reported that curcumin combined with bortezomib could significantly improve bortezomib,s ability of apoptosis induction of mult iple myeloma cell.This research was to study and compare the curative effect and adverse reaction of curcumin combined BD regimen and BD regimen for t he treatment of multiple myeloma through the retrospective analysis, and to provide a basis for the clinical use of curcumin combined with BD regimen in t he treatment of multiple myeloma.Methods We select 40 initial treatment patients of multiple myeloma from 2013-10 to 2015-12 in the hematology of the First Affiliated Hospital of Zhengzhou U niversity as the research objects,of which there are 19 males and 21 females,fr om 43-71 years old,median age 56 years old,Ig G 20 cases,Ig A 10 cases,κ lig ht chain 3 cases and λ light chain 7 cases);Durie-Salmon Staging System(DS): stage I 13 cases,stage II 7 cases,stage III 20 cases.International Staging Syste m(ISS):stage I 7 cases,stage II 21 cases,stage III 12 cases.Basing on patients’ t reatment,they are divided into two groups,there are 20 patients in curcumin co mbined with BD regimen group,including 10 males and 10 females,from 43-70 years old,median age 57 years old,Ig G 10 cases,Ig A 5 cases,κ light chain 3 c ases and λ light chain 2 cases):Durie-Salmon Staging System(DS): stage I 6 ca ses,stage II 3 cases,stage III 11 cases.International Staging System(ISS):stage I 3 cases,stage II 12 cases,stage III 5 cases; There are 20 patients in BD regime n group,including 9 males and 11 females,from 47-71 years old,median age 55 years old,Ig G 10 cases,Ig A 5 cases,κ light chain 0 cases and λ light chain 5 cases);Durie-Salmon Staging System:stage I 7 cases,stage II 4 cases,stage III 9 cases.International Staging System:stage I 4 cases,stage II 9 cases,stage III 7 cases. We observe and record the clinical features, the therapeutic effect and adverse events of the two groups.Results 1.Curative effect:The percentage of decrease in M protein:after three cours es of treatment,the average of observation group is 88.3%,standard deviation is 16.8%,the average of control group is 63.8%,standard deviation is 37.8%,P=0.012;The negative-converting rate of M protein: after three courses of treatme nt,observation group is 55%(11/20),control group is 20%(4/20),P=0.029;The incidence of hemoglobin rising more than 10 g/L:after four courses of treatm ent,observation group is 90%(18/20),control group is 55%(11/20),P=0.013;The decline of β2-MG:after three courses of treatment,the average of observati on group is 1.7mg/L,standard deviation is 3.0mg/L,the average of control group is 1.3mg/L,standard deviation is 3.7mg/L,P=0.717;The percentage of decrease i n monoclonal plasma cell:after three courses of treatment,the average of observ ation group is 31.8%,standard deviation is 24.5%,the average of control group is 22.2%,standard deviation is 26.7%,P=0.252;The negative-converting rate of urine Bence-Jones protein:after three courses of treatment,observation group is 71.4%(10/14),control group is 46.2%(6/13),P=0.024. 2.Adverse events:The incidence rate of Adverse reactions:Observation group is 50%(10/20),peripheral neuropathy(week of hand,foot and mouth numb, etc)in 10 cases, gastrointestinal reactions such as nausea vomit, loss of appetite in 4 cases, edema in lower extremity in 2 cases, infection in 2 cases,liver injury in 1 case,rash in 1 case; Control group is 55%(11/20),peripheral neuropathy(week of hand,foot and mouth numb, etc)in11 cases, gastrointestinal reactions such as nausea vomit, loss of appetite in 5 cases, edema in lower extremity in 3 cases, infection in 3 cases, low potassium in 1 cases.The incidence of adverse reactions in two groups had no significant difference(χ2= 0.100,P=0.752>0.05),the incidence of adverse reactions in two groups had also no significant difference(P>0.05).Conclusion Curcumin combined with BD regimen can significantly improve the complete response rate of multiple myeloma.