血液科

订阅

MedSci主页 / 所有栏目 / 血液科

Blood：采用硼替佐米治疗的915位系统性淀粉样变患者的预后

2019-10-04 MedSci MedSci原创

硼替佐米系统性淀粉样变血液学缓解dFLC
关注

硼替佐米是AL淀粉样变(AL)的标准疗法，但对缓解持续时间的了解知之甚少。既往研究发现治疗后低淀粉样变和无淀粉样变血清游离轻链(dFLC)低于10mg/L(低dFLC反应)的差异可预测低dFLC (20-50mg/L)患者的存活率。近日，blood上发表了一篇杂志，Manwani等人报告了前期使用硼替佐米治疗AL的最大队列的结果，以及dFLC<10mg/L对患者的影响。该队列共包含915位采

硼替佐米是AL淀粉样变(AL)的标准疗法，但对缓解持续时间的了解知之甚少。既往研究发现治疗后低淀粉样变和无淀粉样变血清游离轻链(dFLC)低于10mg/L(低dFLC反应)的差异可预测低dFLC (20-50mg/L)患者的存活率。


近日，blood上发表了一篇杂志，Manwani等人报告了前期使用硼替佐米治疗AL的最大队列的结果，以及dFLC<10mg/L对患者的影响。该队列共包含915位采用硼替佐米治疗的新确诊的AL患，评估的项目有血液学缓解情况、6个月时的dFLC、器官缓解情感、总体存活率和到二次治疗的时间（TNT）。TNT分析不包括未进行二次治疗就死亡的患者。


总体缓解率为65%，完全缓解率/非常好的部分缓解/低dFLC缓解率达到49%。在获得严格的dFLC缓解的患者中，dFLC


综上所述，前期采用硼替佐米治疗可获得持久的血液缓解。严格的dFLC缓解可预测TNT延长和较好的器官缓解。


原始出处：


Richa Manwani， et al.A prospective observational study of 915 patients with systemic AL amyloidosis treated with upfront bortezomib.Blood 2019 ：blood.2019000834； doi： https：//doi.org/10.1182/blood.2019000834


本文系梅斯医学（MedSci）原创编译，转载需授权！

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2017175, encodeId=3ddc201e175ef, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Sat Jan 18 20:38:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373892, encodeId=c1063e38928f, content=已学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20231215/ac08b4d4cecf4bd3b9af86e00dcbca38/f6b6a60efd854ff191eb5c611ec7dd12.jpg, createdBy=8afb2071832, createdName=15938038573红旗飘飘, createdTime=Mon Oct 14 06:49:16 CST 2019, time=2019-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405177, encodeId=369214051e7ca, content=<a href='/topic/show?id=cb6e6591850' target=_blank style='color:#2F92EE;'>#淀粉样变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65918, encryptionId=cb6e6591850, topicName=淀粉样变)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ca02527521, createdName=xjy03, createdTime=Sun Oct 06 13:38:00 CST 2019, time=2019-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373533, encodeId=24753e353356, content=学习了，很有用，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Oct 05 00:43:10 CST 2019, time=2019-10-05, status=1, ipAttribution=)]
    2020-01-18 qingrejiedu

    #系统性#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2017175, encodeId=3ddc201e175ef, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Sat Jan 18 20:38:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373892, encodeId=c1063e38928f, content=已学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20231215/ac08b4d4cecf4bd3b9af86e00dcbca38/f6b6a60efd854ff191eb5c611ec7dd12.jpg, createdBy=8afb2071832, createdName=15938038573红旗飘飘, createdTime=Mon Oct 14 06:49:16 CST 2019, time=2019-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405177, encodeId=369214051e7ca, content=<a href='/topic/show?id=cb6e6591850' target=_blank style='color:#2F92EE;'>#淀粉样变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65918, encryptionId=cb6e6591850, topicName=淀粉样变)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ca02527521, createdName=xjy03, createdTime=Sun Oct 06 13:38:00 CST 2019, time=2019-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373533, encodeId=24753e353356, content=学习了，很有用，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Oct 05 00:43:10 CST 2019, time=2019-10-05, status=1, ipAttribution=)]
    2019-10-14 15938038573红旗飘飘

    已学习

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2017175, encodeId=3ddc201e175ef, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Sat Jan 18 20:38:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373892, encodeId=c1063e38928f, content=已学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20231215/ac08b4d4cecf4bd3b9af86e00dcbca38/f6b6a60efd854ff191eb5c611ec7dd12.jpg, createdBy=8afb2071832, createdName=15938038573红旗飘飘, createdTime=Mon Oct 14 06:49:16 CST 2019, time=2019-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405177, encodeId=369214051e7ca, content=<a href='/topic/show?id=cb6e6591850' target=_blank style='color:#2F92EE;'>#淀粉样变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65918, encryptionId=cb6e6591850, topicName=淀粉样变)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ca02527521, createdName=xjy03, createdTime=Sun Oct 06 13:38:00 CST 2019, time=2019-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373533, encodeId=24753e353356, content=学习了，很有用，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Oct 05 00:43:10 CST 2019, time=2019-10-05, status=1, ipAttribution=)]
    2019-10-06 xjy03

    #淀粉样变#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2017175, encodeId=3ddc201e175ef, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Sat Jan 18 20:38:00 CST 2020, time=2020-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373892, encodeId=c1063e38928f, content=已学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20231215/ac08b4d4cecf4bd3b9af86e00dcbca38/f6b6a60efd854ff191eb5c611ec7dd12.jpg, createdBy=8afb2071832, createdName=15938038573红旗飘飘, createdTime=Mon Oct 14 06:49:16 CST 2019, time=2019-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405177, encodeId=369214051e7ca, content=<a href='/topic/show?id=cb6e6591850' target=_blank style='color:#2F92EE;'>#淀粉样变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65918, encryptionId=cb6e6591850, topicName=淀粉样变)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2ca02527521, createdName=xjy03, createdTime=Sun Oct 06 13:38:00 CST 2019, time=2019-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373533, encodeId=24753e353356, content=学习了，很有用，不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sat Oct 05 00:43:10 CST 2019, time=2019-10-05, status=1, ipAttribution=)]
    2019-10-05 飛歌

    学习了，很有用，不错

    0

相关资讯

J Hematol Oncol：套细胞淋巴瘤自体造血干细胞移植后 硼替佐米+利妥昔单抗疗效喜人

2018年6月，美国学者在《J Hematol Oncol》发表了套细胞淋巴瘤（MCL）患者巩固自体造血干细胞移植（AHCT）后硼替佐米和利妥昔单抗维持联合治疗的多中心2期试验。

CLIN CANCER RES：Evofosfamide联合硼替佐米治疗复发/难治性多发性骨髓瘤

病变骨髓中的缺氧情况为多发性骨髓瘤提供了新的治疗靶点。CLIN CANCER RES近期发表了一篇文章，研究evofosfamide联合地塞米松，联合硼替佐米以及地塞米松质量复发/难治性多发性骨髓瘤的效果。

Blood：卡非佐米相比硼替佐米可延长复发性/难治性多发性骨髓瘤患者的无进展存活期和总体存活期，且不受基础肾功能影响

ENDEACOR试验表明，对于复发性/难治性多发性骨髓瘤（RRMM）患者，卡非佐米（56mg/m2）联合地塞米松（Kd56）相比硼替佐米和地塞米松（Vd）治疗的无进展存活期（PFS）更长。现研究人员进行多重探索性亚组分析，根据基础肾功能评估Kd56与Vd的治疗效果。意向治疗人群包含929位患者，根据肌酐清除率[CrCL]分成三个亚组：I）≥15~＜50mL/min：Kd56组85人 vs Vd组9

Blood：3期CLARION研究：卡非佐米和硼替佐米治疗新确诊的多发性骨髓瘤的疗效和安全性对比

Thierry Facon等人开展一3期CLARION研究，对比卡非佐米-美法仑-强的松 (KMP)和硼替佐米-美法仑-强的松(VMP)两种化疗方案用于不能进行移植的新诊断的多发性骨髓瘤(NDMM)患者的疗效和安全性。患者分为KMP组或VMP组，连续治疗9个疗程，每疗程42天。卡非佐米的用药方案：每个疗程的第1、2、8、9、22、23、29和30天用药（前两次剂量为20 mg/m2，随后为36 m

硼替佐米治疗多发性骨髓瘤骨病1例

患者王某，女，59岁，因“腰部疼痛伴活动受限40余天。”来本院骨科住院治疗。患者于2017年10月无明显诱因出现腰部疼痛，活动受限，行走困难。于当地医院行腰部X线片示：L1椎体压缩骨折，给予理疗治疗效果欠佳。患者腰背部疼痛加重，活动受限，卧床翻身及坐立起身困难。2017年11月22日来我院骨科住院治疗，查生化示β2-微球蛋白、肌酐偏高，球蛋白正常；腰椎MRI示：胸腰骶椎多椎体及其附件异常改变，考虑

Blood：硼替佐米、来那度胺和地塞米松诱导方案用于多发性骨髓瘤患者骨髓移植前的疗效和安全性

实现并维持高质量的缓解是新确诊的多发性骨髓瘤(NDMM)患者的治疗目标。3期PETHEMA/GEM2012研究，招募了458名不超过65岁的NDMM患者，予以硼替佐米(皮下)+来那度胺+地塞米松(VRD)联合诱导化疗6个疗程，然后予以自体干细胞移植(ASCT)，移植后再予以2疗程的VRD巩固治疗，评估VRD诱导方案的疗效和安全性。研究人员对诱导、移植和巩固阶段的缓解反应均进行了分组分析。随着时间的