多发性骨髓瘤患者硼替佐米治疗相关带状疱疹发病机理及预防策略研究进展

含硼替佐米的化疗方案目前是多发性骨髓瘤的一线治疗方案,研究表明,该方案同时会使患者带状疱疹的发生率增加。硼替佐米治疗致带状疱疹激活的机理以及如何进行合理的预防是临床医师需要解决的问题。阿昔洛韦是第一代无环鸟苷类药物,伐昔洛韦是阿昔洛韦的前体药物,目前阿昔洛韦和伐昔洛韦可用于接受含硼替佐米化疗方案的MM患者带状疱疹的预防。本文对近年来多发性骨髓瘤患者应用硼替佐米后带状疱疹发生的相关机理及预防策略作一综述。

Research Progress on the Related Mechanisms and Prevention Strategies of Bortizomib-related Herpes Zoster

ABSTRACT: Bortezomib is a selective and reversible proteasome inhibitor with significant activity in patients with multiple myeloma (MM). Herpes zoster is a common adverse event associated with the use of bortezomib. There are many evidences supporting that bortezomib is associated with a significant risk of herpes zoster. But how to decrease the occurrence of herpes zoster and the routine use of acyclovir prophylaxis is still an issue of debate. Acyclovir is the first generation of anti-herpes virus drugs, which can enter cells and compete virus thymidine kinase or cell kinase with deoxyribonucleoside. Acyclovir inhibits virus replication by interfering DNA polymerase or binding to the growing DNA strand. Acyclovir is currently used to prevent shingles in MM patients treated with bortezomib. As a precursor drug of acyclovir, valaciclovir oral absorption and bioavailability were both higher than acyclovir. Now acyclovir and valaciclovir prophylaxes can be considered as effective methods to prevent bortizomib-related herpes zoster. In this paper, we will review the related mechanisms and prevention strategies of bortizomib-related herpes zoster.