Clinical Characteristics Of Elderly Patients With Multiple Myeloma And Efficacy Of Bortezomib-Based Chemotherapy

Objective To investigate the clinical characteristics of elderly patients with multiple myeloma and analyze the efficacy of bortezomib-based chemotherapy regimen.Methods A total of 138 patients with MM hospitalized in the Department of Hematology of the Affiliated Hospital of Qingdao University from 2012.1-2016.12 were collected for retrospective analysis.Due to loss of follow-up visits,untreated deaths after treatment,and automatic discards of 13 patients,the final analysis included 125 patients,including 77 males and 48 females.There were 49 elderly MM patients,33 males and 16 females.With the age of 65,the patients were divided into the ≥65-year-old group and the<65-year-old non-elderly group.All patients were diagnosed and classified according to the criteria of the International Myeloma Working Group(IMWG).The clinical manifestations,laboratory indicators,and chemotherapy regimens of 125 MM patients were statistically analyzed and analyzed.The first symptom,stage,type,chemotherapy,efficacy evaluation,overall remission rate,and adverse reactions of 49 elderly MM patients were compared,And use SPSS17.0 software for statistical analysis and draw conclusions.Results The age of onset of MM in 125 patients was 33-80 years old.The median age of onset was 61 years old,76 cases <65 years old,and 49 cases ≥ 65 years old.The most common clinical manifestations of first symptoms at first visit were bone pain(37.71%),chest tightness,belching(5.6%),fatigue(16.8%),foam urine(4%),peripheral neuropathy(3.2%),and abnormal creatinine(2.4 %),fever in 6 cases(4.8%),old and non-elder group bone pain are common first symptoms,but there was no significant difference between the two groups.Independent sample t-test analysis showed that the clinical characteristics of factors other than lactate dehydrogenase,such as hemoglobin,creatinine,serum calcium,and β2 microglobulin,were not related to the age of onset in patients with multiple myeloma.The overall survival(OS)of bortezomib-based chemotherapy regimens in older MM patients was significantly higher than that of conventional chemotherapy regimens,which were 40 months and 26 months,respectively.Adverse reactions,bone marrow suppression and respiratory infections,bortezomib group than traditional chemotherapy group.According to the patient’s age,symptoms and signs at the time of initial diagnosis,complications and other factors,the patients were divided into physical health group and frail group by PS staging.There was no significant difference between the physical health group and the frail group.The treatment of multiple myeloma with bortezomib-based chemotherapy has the advantages of rapid curative effect and less adverse reactions.It is currently a better chemotherapy for the treatment of multiple myeloma and is widely used in clinical practice.Conclusion The clinical features of elderly patients with MM compared with non-elderly patients,lactate dehydrogenase abnormalities more common,decreased hemoglobin,bone destruction,hypoalbuminemia,hypercalcemia and non-elderly group had no significant difference.The overall survival and remission rate of patients treated with bortezomib-based chemotherapy were better than those with traditional chemotherapy,and myelosuppression and respiratory infections were less frequent in adverse reactions.