The Efficacy And Side Effects Of Subcutaneous Injection Of Bortezomib In The Treatment Of Multiple Myeloma

objective: Bortezomib has been widely used in the treatment of multiple myeloma,To further explore the advantages and disadvantages of subcutaneous injection and intravenous injection,and providing clinical reference for domestic treatment,the effect and the side effects of subcutaneous injection and intravenous administration were compared and analyzed in this study.Methods: Clinical data of 166 patients with multiple myeloma treated in Blood department of our hospital from January 2013 to January 2018 were analyzed,among them,117 patients receiving Subcutaneous(SC)injection,49 patients receiving intravenous(IV)infusion.Efficacy was assessed after each course,The effect and the incidence of adverse reactions of patients in the two groups were observed.Meanwhile,the influencing factors of PN were explored.Data were analyzed using SPSS 21.0software and Kaplan-Meier curves.The survival rate was calculated by Log-rank method.The qualitative data were analyzed by chi-square and Fisher Probability test.The measurement data were expressed as ` x ±s,and Student's t test was used(normal distribution data)or nonparametric rank test(Mann-Whitney U test,Non-normal distribution data).logistic regressive was used for correlation analysis,P<0.05 is used for test criterion.Result:after 2?4 or 6courses of treatment,the complete remission(CR)rate,?very good partial remission(VGPR)rate and ?partial response(PR)rate are similar between two groups(P>0.05),but Until the end of the treatment with bortezomib,the rate of?PR in the SC group is higher than the IV group(P<0.001),The PFS are similar between two groups,but the SC group had a longer OS.There was no significant difference in 1-year and 2-year survival rates between the two groups,but the 3-year survival rate in the subcutaneous group was higher than that in the intravenous group.There was no significant difference between different treatment schemes in the SC group.The rate of all levels of PN and the PN above grade 3 are different between the two groups,The SC group had a lower incidence.The incidence of infection was higher in the IV group than in the SC group,No significant differences was found in the other side effects between the two groups,Logistic regression analysis of multiple factors affecting the oneset of PN showed that Age,sex,previous history of hypertension,albumin,creatinine,LDH,bortezormide dose and proportion of initial myeloma cells were not significant(p>0.05),and no statistical significance was found.Conclusion:1.The SC injection of bortezomib had comparable early efficacy compared with IV injection,But the SC group has more course of treatment,so that it has Better long-term outcomes.2.The way of treatment had no effect on the PFS,but the SC group had the longer OS and higher 3-year survival rate.3.It can significantly reduce the occurrence of PN by subcutaneous injection which improved the drug safety,on the other hand,it can reduce the incidence of infection.4.Age,sex,previous history of hypertension,albumin,creatinine,LDH,bortezormide dose and proportion of initial myeloma cells have no effect on the occurrence of PN.