The Evaluation Of Four Courses Bortezomib-based Chemotherapy For Multiple Myeloma

ObjectiveTo explore the efficacy and safety of four courses of bortezomib-based chemotherapy for multiple myeloma.Materials and methodsFrom January 2015 to October 2017,33 patients with newly diagnosed myeloma were collected,and their diagnoses were in accordance with the diagnostic criteria of multiple myeloma.The selected patients were classified according to M protein types: 16 patients with IgG type(48.5%)and 10 patients with IgA type(30.3%).According to the D-S stages,2 cases(6.0%)were in stage IIA,22 cases(66.7%)in stage IIIA,and 9 cases(27.3%)in stage IIIB.The treatment plan was the two-drug regimen of bortezomib plus dexamethasone or the three-drug regimen of bortezomib plus dexamethasone combined with chemotherapy drug.A total of 4 or 8 courses of chemotherapy were completed.After chemotherapy,the efficacy and side effects were evaluated according to the ratio of plasma cells in bone marrow,the changes in the results of ?2-MG and serum immune fixed electrophoresis.ResultsAll patients completed 4 courses therapy,the total effective rate was 93.93%,of which 3 cases(9.09%)were CR,15 cases(45.45%)were VGPR,and 13 cases(39.39%)were PR.Eight patients completed 8 courses of treatment,including 4 cases(50.0%)of CR and 3 cases(37.5%)of VGPR.The ?2-MG,serum immunofixation electrophoresis,and bone marrow plasma cell ratio of patients who completed 4 courses of treatment had statistical significance compared with those before treatment(P<0.05).Among the patients who completed 8 courses of treatment,compared with the end of 4 courses of treatment,the main indicators such as ?2-MG,serum immunofixation electrophoresis and bone marrow plasma cell ratio were not significantly improved,and the incidence of peripheral neuropathy was significantly increased.Conclusions 1.Patients with newly diagnosed myeloma receiving bortezomib-based treatment can obtain significant effects after four courses of treatment,with a total effective rate of 93.93%.2.Compared with the end of 4 courses of treatment,the improvement of myeloma indicators were not obvious at the end of 8 courses of treatment,and the incidence of toxic and side effects related to treatment were increased,mainly the increase of incidence of peripheral neuropathy.3.For patients with newly diagnosed myeloma,4 courses of bortezomib-based treatment can achieve ideal efficacy,and can be entered into maintenance treatment or autologous stem cell transplantation.