[Efficacy and Safety of Bortezomib or Thalidomide Combined with rhEPO in the Treatment of Multiple Myeloma].

OBJECTIVE: To explore the efficacy and safety of bortezomib or thalidomide combined with recombinant human erythropoietin (rhEPO) in the treatment of multiple myeloma (MM).

METHODS: A total of 80 patients with MM who were treated in the Second People's Hospital of Wuhu from January 2013 to December 2018 were selected as the research subjects, and they were divided into bortezomib group ( n =40) and thalidomide group ( n =40) by the simple randomization method. The bortezomib group received bortezomib regimen combined with rhEPO therapy, and the thalidomide group was given thalidomide regimen combined with rhEPO therapy, and all patients were treated for 3 courses with every 3 weeks as a course of treatment. The clinical efficacy after 3 courses of treatment, and tumor-related biochemical indicators [lactate dehydrogenase (LDH), β2 -microglobulin (β2 -MG), vascular endothelial growth factor (VEGF), apoptosis inhibitory protein Survivin], bone marrow-related indicators [serum M-protein, bone marrow plasma cells, hemoglobin (Hb)] and coagulation function indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), plasminogen activator inhibitor (PAI), total circulating microparticles (TMPs)] before treatment and after 3 courses of treatment were compared between the two groups of patients. The occurrence of adverse reactions during the treatment in the two groups of patients was recorded.

RESULTS: After 3 courses of treatment, the ORR rate of 92.5% in bortezomib group was higher than 90.0% in thalidomide group, but the difference was not statistically significant ( P >0.05). The levels of LDH, β2 -MG, VEGF, Survivin, serum M-protein, bone marrow plasma cells, APTT, PT, PAI and TMPs in the two groups after 3 courses of treatment were significantly lower or shorter than those before treatment, and the above indicators in bortezomib group were significantly lower or shorter than those in thalidomide group ( P <0.05). After 3 courses of treatment, the expression level of Hb in the two groups was significantly higher than that before treatment, and the Hb level in bortezomib group was significantly higher than that in thalidomide group ( P <0.05). During the treatment process, the incidence rates of adverse reactions in bortezomib group were significantly lower than those in thalidomide group ( P <0.05).

CONCLUSION: Thalidomide regimen or bortezomib regimen combined with rhEPO has similar clinical efficacy on MM, but bortezomib regimen combined with rhEPO is more prominent and safer on improving tumor-related biochemical indicators, bone marrow-related indicators and coagulation status in patients with MM.