Efficacy And Cost Analysis Of Bortezomib?Dexamethasone And Thalidomide In The Treatment Of Multiple Myeloma

BackgroundMultiple myeloma(MM)is a kind of malignant plasmacytoma,which is characterized by abnormal clonal proliferation of malignant plasmacytes in bone marrow microenvironment,resulting in dysfunction of related organs.In recent years,with the development of medical level,the treatment of MM has been enriched.However,due to the age of onset of the disease,the patient can not tolerate some chemotherapy drugs or bone marrow transplantation,and the new drugs are expensive,so the clinical treatment has been seriously limited.In this study,40 patients with MM treated with bortezomib,dexamethasone and thalidomide(BDT)regimen in our hospital were retrospectively analyzed in order to provide reference basis for the choice of treatment regimen for MM patients.PurposeTo explore the short-term efficacy,side effects and cost-effectiveness analysis of BDT regimen for multiple myeloma.MethodFrom February 2016 to August 2018,40 patients with refractory MM were admitted to the Department of Hematology,the first affiliated Hospital of Xinxiang Medical College(23 cases of initial treatment and 17 cases of relapse refractory).The changes of clinical laboratory indexes,ORR and CR rate were analyzed after treatment with BDT regimen,and the adverse reactions during chemotherapy were counted.At the same time,the cost-effectiveness analysis of BDT chemotherapy regimen was carried out according to the new reimbursement policy reform.Data analysis was carried out with SPSS19.0 software.The measurement data was expressed by?x±s was used,the counting data was expressed by percentage(%),and the rank-sum test was used for grade data by X~2 test.A level of significance of P<0.05 was used.Result1.After 4 cycles of chemotherapy with BDT regimen,the levels of M protein,?2-MG and hemoglobin were significantly decreased in myeloma cells(P<0.05).2.The total remission rate was 75.0%(30/40),and the deep remission rate was37.5%(15/40).Among them,5 patients had complete remission,10 patients had very good partial remission,15 patients had partial remission,and 7 patients had stable disease.Disease progression was found in 3 patients.There was a statistical difference in the overall response rate between the two groups(P<0.05)..3.Adverse reactions are tolerable in the course of treatment and can continue to complete prescribed chemotherapy after symptomatic treatment.4.The cost-to-efficacy ratio of BDT was 1126.3 yuan,and the cost-effectiveness ratio was 383.7 yuan after sensitivity analysis of the above results due to the reform of the new rural cooperative care system.ConclusionBortezomib,dexamethasone and thalidomide regimen in the treatment of multiple myeloma have better therapeutic efficacy,side effects can be tolerated,and the price is moderate,it is worth popularizing in clinical practice.