目的：探討蛋白酶體抑制劑——硼替佐米對初治多發性骨髓瘤的療效及對移植造血干細胞采集的影響。方法：對一例初發的中年男性多發性骨髓瘤患者使用硼替佐米+地塞米松+反應停（VTD）的方案進行化療，獲得緩解后采集外周血造血干細胞。結果：應用以硼替佐米為基礎的方案治療3個療程后，患者即獲得完全緩解；完成4個療程化療后成功采集足夠數量的外周血造血干細胞；完成6個療程化療后，進入維持治療，至今已完全緩解17個月。治療過程中除惡心、嘔吐外無其他明顯不良反應。結論：硼替佐米用于初治多發性骨髓瘤有良好的治療效果，不良反應少，不影響造血干細胞采集。
ObjectiveTo investigate the efficacy and safety of bortezomib combined with dexamethasone and thalidomide regimens on aged patients with multiple myeloma. MethodsA total of 166 multiple myeloma patients were selected between January 2009 and June 2013; all patients were assigned to regimens of T-VD or T-VAD named T-VD group or T-VAD group (with 25 patients in T-VD group and 29 in T-VAD group). Efficacies and toxicities were analyzed and compared after two cycles. ResultsOverall response rate (OR) in T-VD group was 84.0%; there was 6 patients achieved complete response (OR) or very good partial response (VGPR) (24.0%). However, Overall response rate (OR) in T-VAD group was 48.3%; there was only one patient achieved CR or VGPR (3.4%); significant difference between two groups was found (χ2=7.513, P<0.05). The major adverse reactions were debilitation, nausea, vomiting, myelo-suppression, cardiac toxicity, and peripheral neuropathy. There were highest incidence of nausea and vomiting in T-VAD group compared to T-VD group (χ2=5.794, P<0.05). ConclusionBortezomib combined with dexamethasone and thalidomide regimens is effective and safe, which can be widely used for aged patients with multiple myeloma.