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| Effects of Isazomib Combined with Dexamethasone and Thalidomide in the Treatment of Refractory Multiple Myeloma |
| WEI Bing, ZHU Taigang, LI Yuehong, et al |
| General Hospital of Anhui Wanbei Coal and Power Group, u Anhui Suzho 234000, China |
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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.
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2022, Vol. 28 
