Observation And Analysis Of Bortezomib In Treatment Of 50 Cases Of Multiple Myeloma Caused Peripheral Neuropathy

Objective:Observe and analyze the probability of peripheral neuropathy after treatment with Bortezomib in newly diagnosed multiple myeloma(MM)and relapsed or refractory multiple myeloma(MM)patients,to guide the dosage and frequency of Bortezomib that patients used in clinical work.So as to reduce the occurrence of adverse reactions.Methods: A total of 50 patients with multiple myeloma admitted to the Department of Hematology in the First Affiliated Hospital of China Medical University,who agreed to receive bortezomib during the two years from January 2016 to December 2017 were selected.The drug dose was calculated at 1.3 mg / m2 and was administered subcutaneously on days 1,4,8 and 11,and dexamethasone 15-20 mg per day,oral or intravenous infusion × 8 days;with or without liposomal doxorubicin 20 mg per day,intravenous infusion × 2 days;with or without cyclophosphamide 0.4g per day,intravenous infusion × 4 days;with or without thalidomide 100 mg once night × 4days.21 d for a course of treatment,if after 2 courses of treatment or stable condition,then continue to apply 2 to 4 courses;if the disease progresses,then stop treatment.Results:Among those 50 patients,the probability of peripheral neuropathy was 24%after two courses of treatment,and the probability was increased to 50% after the treatment was continued until four courses.Analysis of the degree of peripheral neuropathy found that after 2 courses of treatment,76% had no peripheral neuropathy,12% of patients had a degree I peripheral neuropathy,and the probability of a degree II peripheral neuropathy was 10%.2% of patients had grade III lesions,and 6.25% of patients had newly grade III lesions after 4 courses of treatment.For the prevention and treatment of adverse reactions,8% of the patients had received neurotrophic drugs such as Methylcobalamin and Mudan Granules before adverse reactions occurred,and 20% of patients received neurotrophic drugs after adverse reactions.No patient choosed to reduce the dose of Bortezomib,4% of patients stopped using Bortezomib instead of taking new drugs such as lenalidomide or choosing conventional chemotherapy.Conclusion:1.Bortezomib treatment of peripheral neuropathy in multiple myeloma patients is common.2.As the course of treatment increases,the probability of its peripheral neuropathy increases.3.As the course of treatment increases,the severity of peripheral neuropathy increases.4.The use of Methylcobalamin,Mudan granules and other neurotrophic drugs before the onset of peripheral neuropathy to reduce the incidence of adverse reactions,the effectiveness of which remains to be further confirmed.