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Efficacy of Bortezomib Combined with Cyclophosphamide and Dexamethasone in the Treatment of Multiple Myeloma and Its Influence on Renal Function Indexes and Adverse Reactions |
WANG Meijia, YANG Lihua, YAN Qingxia |
Chengdu Shangjin Nanfu Hospital, Sichuan Chengdu 610000, China |
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Abstract Objective: To investigate the efficacy of bortezomib combined with cyclophosphamide and dexamethasone (VCD regimen) in the treatment of multiple myeloma (MM) and its influence on renal function indexes and adverse reactions. Methods: 112 patients with MM were randomly divided into control group and observation group according to the random number table method, with 56 cases in each group. Control group was given thalidomide, cyclophosphamide and dexamethasone chemotherapy (CTD regimen), and observation group was given bortezomib, cyclophosphamide and dexamethasone chemotherapy (VCD regimen), and they were treated for 10 courses by taking 3 weeks as a course of treatment. The clinical efficacy of the two groups was evaluated and the blood test results and renal function indexes were compared between the two groups before and after treatment, and the adverse reactions were observed in the two groups. Results: The total clinical effective rate in observation group was significantly higher than that in control group (92.86% vs 71.43%) (P<0.05). After 10 courses of treatment, the serum M protein content, bone marrow plasma cell ratio and blood β2 microglobulin (β2-MG) of the two groups were significantly lower than those before treatment (P<0.05) while the levels of serum hemoglobin (Hb) and platelet factor 4 (PF4) were significantly higher than those before treatment (P<0.05), and the changes in observation group were significantly more than those in control group (P<0.05). After 10 courses of treatment, the levels of blood urea nitrogen (BUN), serum creatinine (SCr) and uric acid (UA) in observation group were significantly lower than those before treatment and those in control group (P<0.05). There were no statistically significant differences in the incidence rates of thrombocytopenia, leukocytopenia, neutropenia, fatigue, nausea and abdominal distension and peripheral neuropathy between the two groups (P<0.05). Conclusion: Bortezomib combined with cyclophosphamide and dexamethasone has a significant efficacy in the treatment of MM. It can effectively reduce the serum M protein, bone marrow plasma cell ratio and β2-MG, and promote the increase of serum Hb content and high-level expression of PF4. And it can play a preventive and ameliorating role in early renal function damage, with mild toxic and side effects and better clinical safety.
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