浆细胞病_培训课件.ppt

* Slide 133. Bortezomib vs High-Dose Dexamethasone in Relapsed MM: Efficacy Summary Efficacy of bortezomib was superior compared with dexamethasone in relapsed MM Treatment with bortezomib resulted in significantly greater time to progression, higher response rates, and improved survival Richardson P et al. Oral presentation at the 46th Annual Meeting of the American Society of Hematology; December 4–7, 2004; San Diego, California [abstract 336.5] * * * * * For VISTA EBMT* Response Criteria *European Group for Blood and Marrow Transplant Paraprotein: CR=100% reduction in serum urine; nCR=100% disappearance in serum urine; PR=≥50% reduction in serum ≥90% reduction in urine (or absolute value 200 mg/24hrs) Immunofixation CR= Negative; nCR= Positive; PR= Not required Bone Marrow: CR=5% plasma cells; nCR=5% plasma cells; PR=5% plasma cells Bone DiseaseCR= Stable or improvednCR= Stable or improved; PR= Stable or improved Plasmacytomas: CR= No plasmacytomas; nCR= No plasmacytomas; PR= Decreased by ≥50% Bladé et al. Br J Haematol 1998;102:1115-23 * * * CR, complete response; HR, hazard ratio; mos, months; MP, melphalan/prednisone; OS, overall survival; Pts, patients; VISTA, Velcade as Initial Standard Therapy in Multiple Myeloma: Assessment With Melphalan and Prednisone; VMP, Bortezomib/melphalan/prednisone; yr, year. * According to: Mateous et al. (Haematologica 2008; 93(4), 560-565) VMP is highly active and well tolerated in elderly patients with newly diagnosed multiple myeloma, with 85% of patients alive at 3 years. Moreover, VMP may overcome the poor prognostic impact of various factors, particularly cytogenetic abnormalities. * * * * * * * * * * * * Incidence of all grades reported. * * Incidence of all grades reported. * For fluid intake i.e. water, Ricelyte, Pedialyte, sports drinks, diluted fruit juices and broth. Loperamide (Imodium) 4 mg followed by 2 mg every 4 hours or after each unformed stool (maximum 16mg/day). May take 4 mg every 4 hours