减少剂量硼替佐米治疗成人多发性骨髓瘤的疗效:单中心经验

Jeremiah R. Vallente, C. F. N. Cortez, M. Mirasol
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摘要

目标 硼替佐米小瓶共享通常用于在资源有限的环境中最大限度地治疗多发性骨髓瘤(MM)患者。这种策略最大限度地减少了治疗延迟,但减少了患者接受的硼替佐米剂量。在此,我们旨在确定接受小剂量硼替佐米治疗的菲律宾MM患者的治疗模式和结果。方法 回顾性回顾了2016年至2019年在我院就诊并接受小剂量硼替佐米治疗的47名MM成年患者的记录。后果 诊断时患者的中位年龄为55岁;59.6%为男性。VCD(硼替佐米、环磷酰胺、地塞米松)方案是最常用的(70.7%)硼替佐米基治疗方案。在新诊断的患者中,以硼替佐米为基础的治疗的总有效率为79.3%。未达到中位总生存率。单因素分析表明,血红蛋白水平影响反应,而年龄、血红蛋白和钙水平、诱导方案的选择以及反应的深度都对生存率有影响。结论 这项研究首次调查了减少剂量硼替佐米在多发性骨髓瘤治疗中的实际结果,并可能提供初步证据,证明在资源有限的情况下,共享硼替佐米小瓶是治疗多发性MM的一种可接受的策略。
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Treatment Outcomes with Reduced-Dose Bortezomib in Adult Patients with Multiple Myeloma: A Single-Center Experience
Objectives Bortezomib vial-sharing is commonly employed to maximize the treatment of patients with multiple myeloma (MM) in resource-limited setting. This strategy minimizes delays in treatment but reduces the dose of bortezomib received by the patient. Herein, we aimed to determine the treatment patterns and outcomes in Filipino patients with MM who received reduced-dose bortezomib. Methods The records of 47 adult patients with MM, seen at our institution from 2016 to 2019 and treated with reduced-dose bortezomib, were retrospectively reviewed. Results The median age of the patients at diagnosis was 55 years; 59.6% were male. VCD (bortezomib, cyclophosphamide, dexamethasone) regimen was the most commonly used (70.7%) bortezomib-based treatment. Among the newly diagnosed patients, bortezomib-based treatment afforded an overall response rate of 79.3%. The median overall survival was not reached. Univariate analysis showed that the hemoglobin level affected response while age, hemoglobin and calcium levels, the choice of induction regimen, and the depth of response all had an impact on survival. Conclusion This study is the first to investigate the real-world outcomes of reduced-dose bortezomib in MM treatment and may provide initial evidence that bortezomib vial-sharing is an acceptable strategy in the treatment of MM in resource-limited setting.
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