硼替佐米治疗多发性骨髓瘤患者发生感染的临床特征及危险因素分析 点击下载
| 论文标题： | 硼替佐米治疗多发性骨髓瘤患者发生感染的临床特征及危险因素分析 |
| 英文标题： | |
| 中文摘要： | 目的 研究多发性骨髓瘤（MM）患者使用硼替佐米治疗后发生感染的临床特征及潜在危险因素。方法回顾性收集2021年10月至2025年2月苏州大学附属第二医院血液科接受以硼替佐米为基础治疗方案的MM患者的临床资料，主要包括人口学特征、MM的疾病特征、用药方案、感染发生情况及相应处理措施、预防性用药等；对MM合并感染的潜在危险因素进行单因素及多因素Logistic回归分析。结果在284例使用硼替佐米的MM患者中，132例患者至少发生了1次感染（占46.5%），感染类型以呼吸道感染和消化道感染为主。单因素分析结果显示，初诊年龄、病理分型、骨髓抑制分级是MM患者发生感染的影响因素（P＜0.05）。进一步分析两种主要感染类型的影响因素，结果显示，性别、初诊年龄、病理分型、治疗方案、吸烟史是MM患者发生呼吸道感染的影响因素（P＜0.05）；BMI、病理分型、治疗方案、骨髓抑制分级是MM患者发生消化道感染的影响因素（P＜0.05）。多因素Logistic回归分析结果显示，年龄≥70岁、治疗前存在Ⅳ级骨髓抑制为MM患者发生感染的危险因素，而IgG-λ型为MM患者发生感染的保护因素（P＜0.05）。结论以硼替佐米为基础治疗方案的MM患者感染发生率较高，并以呼吸道和消化道感染为主；初诊年龄、骨髓抑制分级、病理分型为MM患者发生感染的影响因素。 |
| 英文摘要： | OBJECTIVE To study the clinical characteristics and potential risk factors for infection in patients with multiple myeloma （MM） following treatment with bortezomib. METHODS Clinical data were retrospectively collected from MM patients who received bortezomib-based treatment regimens at the Department of Hematology， the Second Affiliated Hospital of Soochow University， from October 2021 to February 2025. The collected data primarily included demographic characteristics， disease characteristics of MM， treatment regimens， occurrence of infections and corresponding management measures， and prophylactic medication use. Univariate and multivariate Logistic regression analyses were conducted to identify potential risk factors for MM complicated with infection. RESULTS Among the 284 MM patients treated with bortezomib， 132 patients （46.5%） experienced at least one infection. The predominant types of infections were respiratory tract infections and gastrointestinal infections. Univariate analysis showed that age at initial diagnosis， pathological classification， and grade of myelosuppression were influencing factors for infection in MM patients （ P ＜0.05）. Further analysis of influencing factors for the two main types of infections revealed that sex， age at initial diagnosis， pathological classification， treatment regimen， and smoking history were influencing factor s for respiratory tract infections in MM patients （ P ＜0.05）； BMI， pathological classification， treatment regimen， and grade of myelosuppression were influencing factors for gastrointestinal infections in MM patients （ P ＜0.05）. Multivariate Logistic regression analysis indicated that age≥70 years and the presence of grade Ⅳ myelosuppression before treatment were risk factors for infection in MM patients， while the IgG-λ type was a protective factor against infection （ P ＜0.05）. CONCLUSIONS The incidence of infection is relatively high in MM patients receiving bortezomib-based treatment regimens， with respiratory and gastrointestinal infections being the most common. Age at initial diagnosis， grade of myelosuppression， and pathological classification are influencing factors for infection in MM patients. |
| 期刊： | 2026年第37卷第07期 |
| 作者： | 蒋文婷；周洁；吕波；施爱明；李炳宗；潘杰 |
| 英文作者： | JIANG Wenting，ZHOU Jie，LYU Bo，SHI Aiming，LI Bingzong，PAN Jie |
| 关键字： | 多发性骨髓瘤；硼替佐米；感染；危险因素；真实世界研究 |
| KEYWORDS： | multiple myeloma； bortezomib； infection； risk factors； real-world study |
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