| Objective:To analyse retrospectively clinical features,therapeutic effect and prognosis of newly treated multiple myeloma patients treated by bortezomib-based chemotherapy.Methods: Analyse retrospectively 58 cases of newly treated multiple myeloma(MM)patients diagnosed in our hospital between 2014.1.1-2018.1.1 and treated with chemotherapy based on bortezomib.All patients were diagnosed according to 《 the guidelines for the diagnosis and management of multiple myeloma in China(2017 revision)》.All patients received at least two courses of chemotherapy containing bortezomib,which was subcutaneously injected with 1.3mg/m2/d(1,4,8,11 days),and including BD(bortezomib dexamethasone).BDT(bortezomib dexamethasone thalidomide),BCD(bortezomib dexamethasone cyclophosphamide),BAD(bortezomib dexamethasone doxorubicin)chemotherapy regimen.During the first course of treatment,the following information was collected: blood routine,liver and kidney functions,electrolytes,and lactate dehydrogenase,blood immunoglobulin,serum immunofixation electrophoresis,bone marrow morphology,multiple myeloma FISH gene examination.After completing two courses of chemotherapy,all patients were evaluated according to IMWG criteria,and the disease progression-free survival period was recorded from the beginning of the first use of borotezomib-based chemotherapy to2018.12.31.Results:1.Among the 58 patients,CR(18 cases)rate was 31.03%,PR(27 cases)rate was 46.55%,SD(8 cases)rate was 13.80%,PD(5cases)rate was 8.62%,and the total effective rate was 77.59%..2.The therapeutic effect was compared among the groups according to the age,course of disease,ISS Ⅲ stage,IGH gene,1q21 gene and RB1 gene.The P value was less than 0.05.3.Patient PFS refers to the period from the beginning of the first course of bortezomib-based chemotherapy to the progression of the disease or until 31 December 2018.The average PFS was 541 days and the median PFS was 435 days.4.PFS was compared among the groups according to the course of disease,ISS Ⅲ stage,grade of osteopathy,serum corrected calcium,IGH gene and RB1 gene grouping.The P value was less than 0.05.Conclusions: 1.The effective rate of bortezomib in the treatment of multiple myeloma was decreased when the onset age was less than 65 years,course of disease was more than 12 months,ISS Ⅲ stage,serum corrected calcium was more than 2.75 mmol/l,IGH gene breakage,1q21 gene amplification and RB1 gene deletion.2.The prognosis of patients with multiple myeloma treated with bortezomib was poor when the course of disease was > 12 months,stage Ⅲ of ISS,grade 3/4 of osteopathy,serum corrected calcium > 2.75mmol/l,IGH gene breakage and RB1 gene deletion. |
