Abstract：Objective: To investigate the effects of isazomib combined with dexamethasone and thalidomide on bone metabolism, inflammatory state and the levels of serum fibrinogen degradation product (FDP), D-Dimer (D-D) and platelet factor 4 (PF4) in patients with refractory multiple myeloma (mm). Methods: 82 patients with refractory MM in our hospital from September 2019 to March 2021 were randomly divided into study group (n=41) and control group (n=41). The study group was treated with isazomib combined with dexamethasone and thalidomide, and the control group was treated with traditional VAD (vincristine + dexamethasone + adriamycin) for 4 weeks. The remission rates of the two groups were compared with the indexes of serum bone metabolism [Osteocalcin (BGP), alkaline phosphatase (ALP), type I collagen C-terminal peptide (CTX-I)] and inflammatory factor [tumor necrosis factor] before treatment, 2 courses of treatment and 4 courses of treatment-α( TNF-α),C-reactive protein (CRP), interleukin-6 (IL-6)], renal function indexes (blood urea nitrogen (BUN), blood creatinine (SCR)], FDP, D-D and PF4 levels, and the incidence of adverse reactions was counted. Results: Compared with the control group, the disease remission rate of the study group was significantly improved, with statistical difference (75.61%vs51.22%, χ2=5.256, P<0.05); compared with the control group, the study group had 2 courses of treatment and 4 courses of treatment, the serum BGP and ALP levels increased significantly, and the CTX-I level decreased significantly (P<0.05); compared with the control group, the serum CRP, TNF-α, FDP, DD, serum BUN, and SCr levels of the study group were significantly reduced after 2 courses and 4 courses of treatment (P<0.05); during the treatment period, the two groups had adverse reactions, but there was no statistically significant difference in incidence (P>0.05). Conclusion: The treatment of refractory MM patients with isazomib combined with dexamethasone and thalidomide can significantly improve the disease remission rate, further regulate the levels of serum FDP, D-D and PF4, reduce the inflammatory state and improve bone metabolism, and has a certain safety.
魏冰, 李月红, 张晓娇, 朱太岗. 伊沙佐米联合地塞米松沙利度胺治疗难治性多发性骨髓瘤的临床研究[J]. 河北医学, 2022, 28(2): 336-341.
WEI Bing, ZHU Taigang, LI Yuehong, et al. Effects of Isazomib Combined with Dexamethasone and Thalidomide in the Treatment of Refractory Multiple Myeloma. HeBei Med, 2022, 28(2): 336-341.
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2022, Vol. 28 
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