来那度胺联合硼替佐米和地塞米松治疗 多发性骨髓瘤的疗效

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中图分类号：R733.3 文献标志码：A DOI：10.11958/20250356

Abstract：ObjectiveTo investigate the eficacyoflenalidomide combined with bortezomibanddexamethasone in the treatmentof multiple myeloma （MM）and their efectson heat shock protein90（HSP90）mRNA，miR-28-5p，anti-tartrate acid phosphatase 5b（TRACP-5b）and highmobilitygroup protein B1（HMGB1）.MethodsEighty patients with newly diagnosed MM wereselectedanddividedinto thetwo-combination group（4O patients treated with bortezomib and dexamethasone）and the three-combination group （40 patients treated with bortezomibanddexamethasone combined with lenalidomide）acording tothetreatmentmodalities.Real-timefluorescencequantitativepolymerasechainreactionwas used to detect HSP90 mRNA and miR-28-5p levels.Enzyme-linked immunosorbent asy was used to detect TRACP-5b and HMGB1 levels.The clinical eficacy of the2 groups was compared.Levels of HSP90 mRNA，miR-28-5p，TRACP-5b， HMGB1，theimmunecellfunction，renalfunction indexes and the incidence ofadversereactions were comparedbefore and aftertreatment.ResultsThetotaleffectiverateof thethree-combinationgroupwashigherthanthatofthetwo-combination groups （92.50% vs. 75.00% ， P<0.05 ）.Compared with the pretreatment， the levels of HSP9O mRNA，TRACP-5b，blood creatinie （SCr），andurea nitrogen （BUN）decreased inthe2 groupsafter treatment，and which waslower inthethreecombination group than that in the two-combination groups.The levels of miR-28-5p，HMGB1，CD 4+ ，CD3 + and CD4+/CD8+ were elevatedinthe2 groups，and the levels were higher inthethree-combination group thanthose inthetwo-combination group（ P<0.05 ）.There was no significant differencein the incidence of adverse reactions between the two groups. ConclusionLenalidomidecombined withbortezomibanddexamethasone is clinicalleffective，safeandreliable in the treatment of MM.

Keywords：multiplemyeloma; lenalidomide；bortezomib;dexamethasone;HSP9O heat-shockproteins；HMGB1 protein;miR-28-5p;tartrateresistantacidphosphatase5b isoenzyme

多发性骨髓瘤（multiple myeloma，MM）是一种血液系统恶性肿瘤，主要表现为贫血、肾损伤及骨痛等[1-2]。（剩余12076字）