| Objective:To explore the clinical characteristics of patients with multiple myeloma admitted to binzhou medical college affiliated hospital of binzhou city,shandong province from January 2013 to December 2018,and to analyze the efficacy and safety of bortezomib based chemotherapy regimen for MM initially diagnosed.Methods:between January 2013 and December 2018,marina medical establishing affiliated hospital see a doctor first diagnosis in patients with multiple myeloma,generally in these patients,clinical features,laboratory indexes were analyzed retrospectively,including clinical treatment with complete information and to complete at least four course of patients with multiple myeloma,record their gender,age,hemoglobin,platelet,creatinine,serum calcium,? 2 microglobulin,related parameters of lactate dehydrogenase and the number of myeloma cells and treatment plan.According to the treatment regiments,the patients were divided into bortezomib group and non-bortezomib group.The changes of the above-mentioned indexes were evaluated after the second course of treatment,and the patients'treatment status was comprehensively evaluated after the fourth course of treatment,and the clinical efficacy and adverse reactions of the patients in the two groups were retrospectively analyzed.Result:1.From January 2011 to October 2018,145 newly diagnosed MM patients with complete clinical data were collected,including 76 males and 69 females.The incidence rate of MM was 1.09:1 for males and females.The onset age was 27-87 and the median onset age was 57 years.Among them,53 patients with M M who had complete clinical data and completed at least two courses of treatment could evaluate the efficacy of chemotherapy,23 patients in the bortezomib group and 29 patients in the non-bortezomib group.2.There were 75 patients with hemoglobin>85g/L,70 patients with hemoglobin<85g/L,62 patients with serum albumin>35g/L,83 patients with serum albumin<35g/L,81 patients with serum calcium<2.98mmol/L,64 patients with serum calcium>2.98mmol/L,42 patients with lactate dehydrogenase<200g/L,103 patients with lactate dehydrogenase<200g/L and C-reactive protein<10mg/L.There were 95 cases,50 cases with CRP(>10mg/L),119 cases with creatinine(<176.8um mol/L)and 26 cases with creatinine(>176.8um mol/L).3.Among 145 patients,118 cases detected beta-2 microglobulin and the median value of beta-2 microglobulin was 5.1 g/L.Among them,55 cases had beta-2-microglobulin less than 5.5 g/L and 63 cases had beta-2 microglobulin(>5.5 g/L).4.Among 145 patients,35 had plasma cells less than 10%in bone marrow,110 had plasma cells more than 10%in bone marrow,and the median ratio of plasma cells in bone marrow was 16.5%.5.The characteristics of D-S staging of 145 patients were:stage ? 14 cases,stage ? 46 cases,stage ? 85 cases;ISS stage ? 15 cases,ISS stage ? 50 cases,ISS stage ? 80 cases.Clinical typing characteristics:64 cases of IgG type,29 cases of IgA type and 52 cases of light chain type.6.Fifty-three patients with MM who received at least two courses of chemotherapy had complete data,including 27 males and 25 females,aged 41 years,the oldest 79 years,28 patients younger than 65 years,24 patients older than 65 years,23 patients in the bortezomib group and 29 patients in the non-bortezomib group.There was no significant difference in gender,age,stage and classification between the two groups.(P>0.05).The effect of bortezomib group was better than that of non-bortezomib group.The hemoglobin,platelet,creatinine,globulin and beta-2 microglobulin in bortezomib group were improved more obviously than that of non-bortezomib group after two courses of treatment.The total effective rate of bortezomib group was significantly higher than that of non-bortezomib group after four courses of treatment,and the difference was statistically significant(P<0.05).7.The main adverse reactions in the two groups included digestive system adverse reactions,blood system adverse reactions,peripheral neuropathy,infection and so on,which could be improved after symptomatic treatment.The incidence of adverse reactions in non-bortezomib group was significantly higher than that in bortezomib group(P<0.05).8.Conclusion:1.154 newly diagnosed MM patients in our hospital were younger and later in the initial stage.IgG type was the main type of immune classification,and more males than females.2.Bortezomib-based chemotherapy is a safe and effective treatment for newly diagnosed MM patients with high efficiency and mild adverse reactions... |
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