Đánh giá hiệu quả điều trị của phác đồ Bortezomib, Cyclophosphamide và Dexamethasone (VCD) trên bệnh nhân đa u tủy có suy giảm chức năng thận tại Bệnh viện Chợ Rẫy

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Bảo Ngọc Lê, Monivong Cheanh Beaupha Suzanne, Thanh Tùng Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 616 Diseases

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 453-460

Bộ sưu tập: Metadata

ID: 500741

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Đánh giá hiệu quả điều trị của phác đồ bortezomib, cyclophosphamide và dexamethasone (VCD) trên bệnh nhân đa u tủy mới chẩn đoán có suy giảm chức năng thận. Đối tượng và phương pháp nghiên cứu: Đây là nghiên cứu mô tả hồi cứu được thực hiện tại khoa Huyết học, bệnh viện Chợ Rẫy trong khoảng thời gian từ tháng 1 năm 2015 đến tháng 5 năm 2021 ở bệnh nhân từ 18 tuổi trở lên, mới được chẩn đoán đa u tủy và có tăng creatinin máu >
2 mg/dL hoặc giảm độ lọc cầu thận eGFR <
60 mL/phút/1.73m2, được điều trị bằng phác đồ bortezomib, cyclophosphamide và dexamethasone (VCD). Kết quả: Chúng tôi ghi nhận được 43 bệnh nhân có tuổi trung bình là 53,8 ± 9,3 tuổi, nam giới chiếm 76,7%, creatinin máu là 3,79 (2,09 - 5,61) mg/dL. Sau hoá trị với phác đồ VCD 4 chu kỳ có 77,5% bệnh nhân đạt đáp ứng lui bệnh một phần hoặc hơn (³ PR), trong đó đạt lui bệnh một phần rất tốt (VGPR) là 27,5%. Tỷ lệ đáp ứng thận nói chung đạt 85%, trong đó 57,5% đáp ứng hoàn toàn (CRrenal), 10% đáp ứng một phần (PRrenal) và 17,5% đáp ứng tối thiểu (MRrenal). Có sự tương quan thuận có ý nghĩa thống kê giữa đáp ứng thận và đáp ứng lui bệnh sau hoá trị với p = 0,002. Xác suất sống còn toàn bộ (OS) thời gian 3 năm là 72,3%, xác suất sống không tiến triển bệnh thời gian 3 năm là 65,3%. Kết luận: Kết quả nghiên cứu cho thấy hiệu quả điều trị của phác đồ VCD trong cả đáp ứng lui bệnh và cải thiện chức năng thận trên đối tượng bệnh nhân đa u tuỷ mới chẩn đoán có suy giảm chức năng thận.To evaluate the treatment efficacy of bortezomib, cyclophosphamide and dexamethasone (VCD) regimens in newly diagnosed multiple myeloma patients with renal impairment. Materials and Methods: A retrospective descriptive study had been conducted at the Department of Hematology, Cho Ray Hospital during the period from January 2015 to May 2021. Study population included patients who were aged of 18 years and older, newly diagnosed with multiple myeloma, had serum creatinine level greater than 2 mg/dL or decreased glomerular filtration rate eGFR <
60 mL/min/1.73 m2. These patients were treated with regimen of bortezomib, cyclophosphamide, and dexamethasone (VCD). Results: We collected 43 patients with mean age 53.8 ± 9.3 years old, male accounted for 76.7%, serum creatinine level was 3,79 (2,09 - 5,61) mg/dL. After chemotherapy with 4 cycles of VCD regimen, 77.5% of patients achieved partial remission response or better (³ PR), of which very good partial remission (VGPR) was 27.5%. The overall renal response rate was 85%, of which 57.5% had a complete response (CRrenal), 10% had a partial response (PRrenal) and 17.5% had a minimal response (MRrenal). There was a statistically significant positive correlation between renal response and remission response after chemotherapy with p = 0.002. The probability of 3-year overall survival (OS) were 72.3%, the probability of 3-year progression-free survival were 65.3%. Conclusion: The study results showed the treatment efficacy of the VCD regimen in both remission response and renal function improvement in newly diagnosed multiple myeloma patients with renal impairment.

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