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Objective To investigate the efficacy and safety of domestic bortezomibˉbased chemotherapy for patients with multiple myeloma (MM). Methods The clinical data of 60 MM patients treated with domestic bortezomibˉbased chemotherapy regimen (the observation group) in the First Affiliated Hospital of Zhengzhou University from April 2018 to October 2018 were retrospectively analyzed, which were compared with 112 MM patients treated with original treatment regimen (the control group) at the same hospital from November 2010 to November 2014. According to the disease stage, the patients were divided into newly diagnosed MM (NDMM) group and relapsed refractory MM (RRMM) group, and efficacy and adverse reactions of domestic bortezomib were evaluated. Results The total response rate (ORR) of the observation group was 71.7% (43/60), severe complete response (sCR) + complete response (CR) rate was 16.7% (10/60), very good partial response (VGPR) rate was 18.3% (11/60), and partial response (PR) rate was 36.7% (22/60). The ORR of NDMM group (45 cases) and RRMM group (15 cases) was 82.2% (37/45) and 40.0% (6/15), respectively, and the difference was statistically significant (χ2＝ 9.877, P < 0.05). There was no significant difference between ISS stage Ⅰ+Ⅱ and stage Ⅲ [ORR: 75.7% (28/37) vs. 65.2% (15/23), respectively; χ2＝0.764, P >0.05]. ORR and CR rates in the NDMM group and RRMM group of the observation group and the control group were not statistically different (all P>0.05). In the treatment of bortezomibˉbased chemotherapy, the common adverse reaction was peripheral neuropathy, mostly belonging to grade 1-2. Other side effects included hematocytopenia, gastrointestinal events and herpes zoster, which could be alleviated or restored to normality after supportive treatments. One patient died of pulmonary infection, respiratory failure and septic shock during the intermittent period of chemotherapy. Conclusion ORR of domestic bortezomibˉbased chemotherapy in treatment of the patients with MM is high, and the incidence of adverse reactions shows no significant increase compared with original drugs.
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Objective@#To investigate the clinical characteristics and prognostic factors in elderly patients with acute myeloid leukemia(AML).@*Methods@#Clinical data of 232 patients with acute myelocytic leukemia(AML, except for acute promyelocytic leukemia) admitted in our hospital from January 2012 to December 2015 were retrospectively analyzed.Factors affecting complete remission(CR) were analyzed by using χ2 test, and Kaplan-Meier survival analysis was conducted.Univariate and multivariate analysis of prognostic factors were performed by using Log-Rank test and Cox regression model respectively.@*Results@#Of 232 patients, 195 patients received induction chemotherapy, among whom 8 patients died in early phase, efficacy could not be evaluated in 25 cases, with 162 patients for final statistical study.The CR rate was 37.0%(60/162) after the first therapy course, and overall CR rate was 54.9%(89/162). Thirty-seven patients received palliative treatment, among whom 6 patients died in early phase and none achieved CR.Therefore, the 162 patients receiving an induction chemotherapy, whose efficacy can be evaluated, could be clinically analyzed.They were in 60-69 years old(χ2=4.102, P=0.043), with ECOG score≤2(χ2=9.917, P=0.002), NPM1+ FLT3-ITD-(χ2=6.423, P=0.038), favorable karyotypes(χ2=6.033, P=0.049), and related to a higher CR rate.The median overall survival(OS) was 205 days in the 232 patients.Univariate analysis results demonstrated that age(χ2=8.700, P=0.003), white blood cell(WBC) count≥100×109/L(χ2=4.249, P=0.039), karyotypes(χ2=4.807, P=0.028), palliative treatment(χ2=191.221, P=0.000) were influencing factors for the prognosis.Multivariable analysis showed that age(HR=0.464, 95%CI: 0.245-0.877, P=0.018), karyotypes(HR=3.618, 95%CI: 1.491-6.728, P=0.003) and whether or not to receive induction chemotherapy(HR=0.076, 95%CI: 0.030-0.194, P=0.000) were independent influencing factors for OS in elderly patients with AML.@*Conclusions@#The prognosis of elderly patients with AML is affected by multiple factors.Age, karyotypes and whether or not to receive induction chemotherapy are independent influencing factors for OS in elderly patients with AML.
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Objective To investigate the clinical characteristics and prognostic factors in elderly patients with acute myeloid leukemia(AML).Methods Clinical data of 232 patients with acute myelocytic leukemia(AML,except for acute promyelocytic leukemia) admitted in our hospital from January 2012 to December 2015 were retrospectively analyzed.Factors affecting complete remission (CR) were analyzed by using x2 test,and Kaplan-Meier survival analysis was conducted.Univariate and multivariate analysis of prognostic factors were performed by using Log-Rank test and Cox regression model respectively.Results Of 232 patients,195 patients received induction chemotherapy,among whom 8 patients died in early phase,efficacy could not be evaluated in 25 cases,with 162 patients for final statistical study.The CR rate was 37.0％ (60/162) after the first therapy course,and overall CR rate was 54.9％ (89/162).Thirty-seven patients received palliative treatment,among whom 6 patients died in early phase and none achieved CR.Therefore,the 162 patients receiving an induction chemotherapy,whose efficacy can be evaluated,could be clinically analyzed.They were in 60-69 years old (x2 =4.102,P =0.043),with ECOG score≤ 2 (x2 =9.917,P =0.002),NPM1 +FLT3-ITD-(x2 =6.423,P =0.038),favorable karyotypes(x2 =6.033,P =0.049),and related to a higher CR rate.The median overall survival(OS) was 205 days in the 232 patients.Univariate analysis results demonstrated that age(x2 =8.700,P =0.003),white blood cell (WBC) count ≥ 100 × 109/L (x2=4.249,P=0.039),karyotypes(x2=4.807,P=0.028),palliative treatment(x2 =191.221,P=0.000) were influencing factors for the prognosis.Multivariable analysis showed that age(HR =0.464,95％CI:0.245-0.877,P =0.018),karyotypes(HR =3.618,95％CI:1.491-6.728,P =0.003) and whether or not to receive induction chemotherapy (HR =0.076,95 ％ CI:0.030-0.194,P =0.000) were independent influencing factors for OS in elderly patients with AML.Conclusions The prognosis of elderly patients with AML is affected by multiple factors.Age,karyotypes and whether or not to receive induction chemotherapy are independent influencing factors for OS in elderly patients with AML.