The Clinical Characteristics And Curative Effect Observation In Patients With Multiple Myeloma In The Initial Treatment

Objective:To compare the difference in clinical characteristics between patients with normal renal function and renal insufficiency,and to observe the difference in curative efficacy of various chemotherapy plans in multiple myeloma patients combining renal insufficiency.Method:A total of 285 subjects firstly diagnosed as multiple myeloma(MM)patients at our hospital(2008.01-2015.12)excluding 51 losing follow-up patients were recruited in this study.61 subjects with creatinine ≥177umol/L were categorized into renal insufficiency group;173 subjects with creatinine <177umol/L were divided into normal renal function group.Clinical features in two groups of patients were regressively analyzed,and the statistical differnce between their clinical characteristics as well as blood calcium levels before and after correction were measured;patients in renal insufficiency group were further divided into bortezomib group and VAD group based on chemotherapy plans,in order to compare the difference in curative efficacy of possible statistical significance.Result:In the comparison between renal insufficiency group and normal renal function group,significant differences were observed between renal insufficiency and hypercalcemia,hyperuricemia,hemoglobin and myeloma bone disease(p<0.05)while no significant difference was found to age,gender and immunophenotyping(p>0.05).Within renal insufficiency group,no statistical significance was obtained in overal survival in between bortezomib group and VAD group(p=0.06);After two-course of chemotherapy,bortezomib group had 9 cases of CR,5 cases of PR and 6 cases of MR with an overal effective rate of 90.9%;VAD group had 11 cases of CR,9 cases of PR and 10 cases of MR with an overal effective rate of 79.6%.The difference between two groups was statistically significant(p=0.04).Conclusion:Comparing to MM patients with normal renal function,patients with renal insufficiency were prone to combinations with hypercalcemia,hyperuricemia andanemia;much more serious renal damages were found in renal insufficiency MM patients with hypercalcemia,which indicated hypercalcemia was one of the factors resulting in renal damage aggravation;chemotherapy plan including bortezomib was able to improve the renal function in MM patients.