Abstract: Objective To analyze the clinical characteristics and prognosis of bradycardia caused by bortezomib-based combined chemotherapy during clinical applications, and provide reference for clinical safe medication. Methods The clinical data of four patients with plasma cell diseases who suffered from bradycardia after bortezomib-based combined chemotherapy in the Department of Hematology of Xuanwu Hospital was analyzed retrospectively while related literature was reviewed to explore the risk factors and countermeasures for bradycardia caused by bortezomib. Results Four patients developed bradycardia or exacerbation of bradycardia when the cumulative dose of bortezomib ranged from 1.3 to 31.2 mg·m^-2, two of whom had underlying heart diseases. Prolonging the medication interval failed to bring bradycardia under control. However, the four patients had their bradycardia relieved on its own 5 to 21 months after the withdrawal of bortezomib. Conclusion Patients with plasma cell diseases may develop bradycardia after bortezomib-based combined chemotherapy, which may be related to the cumulative dose of bortezomib, the age of patients and underlying heart diseases. During medication, changes of patients' heart rate should be closely monitored, and a reduced dosage or discontinuation should be considered in case of bradycardia.

Key words: bortezomib, bradycardia, plasma cell disease, cumulative dose, underlying heart disease