西南医科大学学报2025，Vol.48Issue(2)：198-205,8.DOI:10.3969/j.issn.2096-3351.2025.02.014
以硼替佐米为基础的多发性骨髓瘤维持治疗真实世界研究
A Real-World Study of Bortezomib-Based Maintenance Therapy in Multiple Myeloma
摘要
Abstract
Objective To analyze the effects of different bortezomib dosing patterns on the efficacy,side effects,and sur-vival outcomes of maintenance therapy for multiple myeloma(MM).Methods This retrospective study analyzed 190 multiple myeloma(MM)patients who did not undergo autologous hematopoietic stem cell transplantation(ASCT)and were treated at the Department of Hematology,West China Hospital of Sichuan University,and the Department of Hematology,the Third Hospital of Mianyang,between January 2010 and December 2020.Patients were divided into two groups based on the maintenance therapy regi-men:Group A(n=66),receiving four doses of bortezomib every three months,and Group B(n=124),receiving six doses every three months.All patients received bortezomib-based maintenance therapy for a total of two years.Treatment efficacy was assessed based on the following criteria:partial remission(PR),very good partial remission(VGPR),complete remission(CR),stringent complete remission(sCR),and progressive disease(PD).The follow-up period was three years.Survival analysis was performed using the Kaplan-Meier method,and prognostic factors were analyzed using the Cox proportional hazards model.Results After two years of follow-up,the number of patients with progressive disease(PD)was 22(33.3%)in Group A and 43(34.7%)in Group B,with no sig-nificant difference in efficacy between the two groups(P=0.098).The 3-year progression-free survival(PFS)rates for Group A and Group B were 57.6%and 67.6%,respectively(P=0.125),and the 3-year overall survival(OS)rates were 70.2%and 78.0%,respec-tively(P=0.232).The PFS and OS were significantly better in the low-risk group compared to the high-risk group(P<0.05).Multi-variate analysis revealed that male gender,high Eastern Cooperative Oncology Group(ECOG)performance status,elevated globulin levels,and treatment interruptions were independent risk factors for disease progression(P<0.05).The incidence of adverse events was 25.8%in Group A and 16.1%in Group B,with no significant difference between the two groups(P=0.111).Risk stratification and efficacy after maintenance therapy were independent factors affecting PFS(P<0.05).Age,risk stratification,and ECOG perfor-mance status were independent prognostic factors for OS(P<0.05).Notably,risk stratification was a common independent risk factor for both PFS and OS.Conclusion Bortezomib maintenance therapy showed better efficacy and safety in different risk stratification and age groups of MM patients,and the treatment regimen in group A was more advantageous in clinical application.关键词
多发性骨髓瘤/硼替佐米/维持治疗Key words
Multiple Myeloma/Bortezomib/Maintenance Therapy分类
医药卫生引用本文复制引用
代明辉,帅晓,吴俣,况小红,李秋玲,王奎..以硼替佐米为基础的多发性骨髓瘤维持治疗真实世界研究[J].西南医科大学学报,2025,48(2):198-205,8.基金项目
四川省科技厅重点研发项目(2022YFS0191) （2022YFS0191）
