The Clinical Analysis Of BD Regimen And TD Regimen In The Treatment Of Elderly Patients With Multiple Myeloma

Objective To compare the curative effect and side-effects of BD regimen and TDregimen in the treatment of elderly patients with multiple myeloma (MM).Methods Data from48elderly patients with multiple myeloma were analyzedretrospectively,24(untreated12, relapse/refractory12) of whom were enrolled in a group ofBD regimen (bortezomib combined with dexamethasone),and another24(untreated13,relapse/refractory11) of whom were treated with TD regimen (thalidomide combined withdexamethasone). The effective rate and survival time and side-effects were compared betweentwo groups. All cases excepted that those who were gave up and were lost of follow-up wereevaluated after4～8cycles.Results The24cases treated with BD regimen in20cases with different degrees ofremission, the total effective rate RR was83.3%, including complete response(CR) in9cases(37.5%), partial response(PR) in11cases (45.8%), stable disease(SD) in2cases (8.3%) andprogressive disease(PD) in2cases (8.3%),and the effective rate of untreated patients andrelapse/refractory patients was91.7%and75.0%. The24cases treated with TD regimen in12cases with different degrees of remission, the total effective rate RR was50.0%, includingcomplete response(CR) in4cases (16.7%), partial response(PR) in8cases (33.3%), stabledisease(SD) in7cases (29.2%) and progressive disease(PD) in5patients (20.8%), and theeffective rate of untreated patients and relapse/refractory patients was46.2%and54.5%. Thedifference of the total effective rate of and the effective rate of untreated patients between BDand TD groups was statistically significant (P <0.05). To compare the two groups aftertreated with BD and TD, the difference of the observation indexes, such as the growth of hemoglobin (g/L), the decrease of serum certainties (μmol/L), the decrease of bloodβ2microglobulin (mg/L) and the decrease of the proportion of plasma cells in bone marrow wasstatistically significant (P <0.05), which is improved more obviously by the VD groupcompared with the TD group. For both groups of follow-up time4~50months, the medianfollow-up of26months, BD live group18cases,23months average survival time, thesurvival rate was75.0%; TD group of14cases of survival, the average survival time in16months, the survival rate was58.3%, the survival time is analyzed by adopting the KaplanMeier-method, use Log-rank test survival (sequential test statistic is5.384, P0.02<0.05),survival compare differences between the two groups have statistical significance (P <0.05).The difference of common adverse reactions between two groups, which include fatigue,constipation, peripheral neuropathy, skin rashes, drowsiness, dizziness, leucopenia andthrombocytopenia, was statistically significant (P <0.05).Conclusion1. BD regimen had higher effective rate in the treatment of elderly patients with multiplemyeloma compared with TD regimen, especially for untreated elder patients, greatlyimproving the quality of patients’ life.2. Compared with TD regimen, the laboratory observation indicators were relievedobviously by BD regimen, which is safe and effective for patients with renal insufficiency.3. Compared with TD regimen, BD regimen can prolong the survival time and get highersurvival rate in the treatment of elderly patients with multiple myeloma.4. The main toxicity of chemotherapy drugs was different in two groups and theside-effects of the BD regimen could be almost controlled and most of elder patients had goodtolerance.5. To sum up, in the treatment of elderly patients with multiple myeloma, the curativeeffect of the BD regimen is definite, which is better than the TD regimen.