摘要
目的探讨来那度胺在初诊多发性骨髓瘤(newly diagnosed multiple myeloma,NDMM)患者化疗中的应用效果。方法选择福建省莆田市第一医院血液科2019年6月—2022年5月收治的NDMM患者80例,采用随机数字表法分为VTD组与VRD组,每组各40例,VTD组化疗方案(硼替佐米^(+)沙利度胺^(+)地塞米松)、VRD化疗方案(硼替佐米^(+)来那度胺^(+)地塞米松)。比较两组临床疗效、细胞免疫指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、炎症因子白细胞介素(interleukin),IL-6、IL-17、转化生长因子(transforming growth factor,TGF-β)水平及不良反应发生情况。结果VRD组临床疗效总有效率高于VTD组,差异有统计学意义(P<0.05);两组化疗前免疫功能比较,差异无统计学意义(P>0.05),化疗后VRD组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于VTD组,差异有统计学意义(P<0.05);两组化疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于化疗前,差异有统计学意义(P<0.05)。两组化疗前炎症因子水平比较,差异无统计学意义(P>0.05),化疗后VRD组IL-6、IL-17、TGF-β水平低于VTD组,差异有统计学意义(P<0.05);两组化疗后IL-6、IL-17、TGF-β水平低于化疗前,差异有统计学意义(P<0.05)。VRD组不良反应发生率虽低于VTD组,但差异无统计学意义(P>0.05)。结论来那度胺在NDMM患者中应用临床疗效显著,与VTD化疗方案比较,VRD化疗方案能改善患者免疫功能与下调炎性因子水平。
Objective To investigate the effect of lenalidomide in chemotherapy in newly diagnosed patients with multiple myeloma(NDMM).Methods A total of 80 NDMM patients admitted to the Department of Hematology of the First Hospital of Putian City from June 2019 to May 2022 were selected and randomly divided into VTD group and VRD group,40 cases in each group,VTD group with chemotherapy regimen(bortezomib^(+)thalidomide^(+)dexamet hasone),VRD chemotherapy(bortezomib^(+)lenalidomide^(+)dexam ethasone).The clinical efficacy,cellular immune indexes(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)),inflammatory factor interleukin IL-6,IL-17,transforming growth factor(TGF)-βlevels and adverse reactions were compared between the two groups.Results The total effective rate of clinical efficacy in VRD group was higher than VTD group,difference was statistically significant(P<0.05).There was no significant difference in immune function between the two groups before chemotherapied(P>0.05).After chemotherapied,VRD group CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were higher than VTD group,difference was statistically significant(P<0.05).The levels of CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)in the two groups after chemotherapied were higher than before chemotherapied.There was no significant difference in the levels of inflammatory factors between the two groups before chemotheraped(P>0.05).After chemotheraped,the levels of IL-6,IL-17 and TGF-βin the VRD group were lower than VTD group,difference was statistically significant(P<0.05);The levels of IL-6,IL-17 and TGF-βin the two groups after chemotherapied were lower than before chemotherapied,difference was statistically significant(P<0.05).Although the incidence of adverse reactions in VRD group was lower than VTD group,but the difference has no statistically significant(P>0.05).Conclusion The clinical efficacy of lenalidomide in NDMM patients is significant.,Comparing with VTD chemotherapy,VRD chemotherapy can improving the immune function and downregulating the level of inflammatory factors.
作者
蔡振杰
林武强
郑合勇
陈秀丽
CAI Zhenjie;LIN Wuqiang;ZHENG Heyong;CHEN Xiuli(Department of Hematology,the First Hospital of Putian City,Putian Fujian 351100,China)
出处
《中国卫生标准管理》
2023年第2期149-152,共4页
China Health Standard Management
关键词
初诊多发性骨髓瘤
硼替佐米
来那度胺
地塞米松
疗效
免疫功能
炎性因子
不良反应
newly diagnosed multiple myelomal
bortezomib
lenalidomide
dexamethasone
efficacy
immune function
inflammatory factors
adverse reactions
