Efficacy of lenalidomide combined with bortezomib and dexamethasone in the treatment of multiple myeloma

doi:10.11958/20250356

Abstract

Abstract:

Objective To investigate the efficacy of lenalidomide combined with bortezomib and dexamethasone in the treatment of multiple myeloma (MM) and their effects on heat shock protein 90 (HSP90) mRNA, miR-28-5p, anti-tartrate acid phosphatase 5b (TRACP-5b) and high mobility group protein B1 (HMGB1). Methods Eighty patients with newly diagnosed MM were selected and divided into the two-combination group (40 patients treated with bortezomib and dexamethasone) and the three-combination group (40 patients treated with bortezomib and dexamethasone combined with lenalidomide) according to the treatment modalities. Real-time fluorescence quantitative polymerase chain reaction was used to detect HSP90 mRNA and miR-28-5p levels. Enzyme-linked immunosorbent assay was used to detect TRACP-5b and HMGB1 levels. The clinical efficacy of the 2 groups was compared. Levels of HSP90 mRNA, miR-28-5p, TRACP-5b, HMGB1, the immune cell function, renal function indexes and the incidence of adverse reactions were compared before and after treatment. Results The total effective rate of the three-combination group was higher than that of the two-combination groups (92.50% vs. 75.00%, P<0.05). Compared with the pretreatment, the levels of HSP90 mRNA, TRACP-5b, blood creatinine (SCr), and urea nitrogen (BUN) decreased in the 2 groups after treatment, and which was lower in the three-combination group than that in the two-combination groups. The levels of miR-28-5p, HMGB1, CD4⁺, CD3⁺ and CD4⁺/CD8⁺ were elevated in the 2 groups, and the levels were higher in the three-combination group than those in the two-combination group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Lenalidomide combined with bortezomib and dexamethasone is clinically effective, safe and reliable in the treatment of MM.

Key words: multiple myeloma, lenalidomide, bortezomib, dexamethasone, HSP90 heat-shock proteins, HMGB1 protein, miR-28-5p, tartrate resistant acid phosphatase 5b isoenzyme

CLC Number:

R733.3

Figures/Tables 7

References 26

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基因	引物序列（5'→3'）	产物大小/bp
HSP90 mRNA	上游：GTCTGCGTATCCGAAAGCAAG	2 568
HSP90 mRNA	下游：CTGAGGGGTGGGGATGATGTC	2 568
miR-28-5p	上游：GGCGTGAGGCTGAGGCTA	47
miR-28-5p	下游：ATGGCTGAGCGAAATTGCGGAC	47
U6	上游：CTCGCTTCGGCAGCACA	150
U6	下游：AACGCTTCACGAATTTGCGT	150

基因	引物序列（5'→3'）	产物大小/bp
HSP90 mRNA	上游：GTCTGCGTATCCGAAAGCAAG	2 568
HSP90 mRNA	下游：CTGAGGGGTGGGGATGATGTC	2 568
miR-28-5p	上游：GGCGTGAGGCTGAGGCTA	47
miR-28-5p	下游：ATGGCTGAGCGAAATTGCGGAC	47
U6	上游：CTCGCTTCGGCAGCACA	150
U6	下游：AACGCTTCACGAATTTGCGT	150

组别	性别（男/女）	年龄/ 岁	病程/ 年	D-S分期（Ⅱ期/Ⅲ期）	ISS分期（Ⅱ期/Ⅲ期）
二联组	21/19	57.61±6.07	2.63±0.37	4/36	10/30
三联组	23/17	57.33±6.25	2.73±0.40	3/37	9/31
t或χ²	0.202	0.272	1.594	0.157	0.069

组别	性别（男/女）	年龄/ 岁	病程/ 年	D-S分期（Ⅱ期/Ⅲ期）	ISS分期（Ⅱ期/Ⅲ期）
二联组	21/19	57.61±6.07	2.63±0.37	4/36	10/30
三联组	23/17	57.33±6.25	2.73±0.40	3/37	9/31
t或χ²	0.202	0.272	1.594	0.157	0.069

组别	n	完全缓解	非常好的部分缓解	部分缓解	病情稳定	病情进展	总有效
二联组	40	2（5.00）	11（27.50）	17（42.50）	7（17.50）	3（7.50）	30（75.00）
三联组	40	5（12.50）	13（32.50）	19（47.50）	2（5.00）	1（2.50）	37（92.50）
χ²							4.501^＊