The Efficacy And Safety Of Pegylated Liposomal Doxorubicin In The Treatment Of Newly Diagnosed Multiple Myeloma

Objective Multiple myeloma is one of common malignant hematologic diseases, Common in elderly patients, In recent years, as China’s aging population, The incidence increased gradually,Chemotherapy remains the main treatment options; Taking into account the part of the patient, the latter must autologous hematopoietic stem cell transplantation, Containing drugs such as doxorubicin, is a conventional first‐line chemotherapy, Its stem cell damage is small, However, the adverse drug reactions, In addition to common nausea, vomiting, hair loss and other side effects, There are bone marrow suppression leading to leukocyte and platelet reduction, Cardiotoxicity cause abnormal heart function;Using a modified formulation, polyethylene glycol liposomes of doxorubicin,By doxorubicin encapsulated in pegylated liposomal delivery system, Compared to conventional doxorubicin, Studies have reported it has played in the process of reducing the side effects of chemotherapy, Multiple myeloma patients improved tolerability and response rate, This study aims to analyze, doxorubicin liposomal doxorubicin instead of the traditional, the treatment of multiple myeloma patients efficiency and safety.Methods Collected in September 2011 ‐2014 in January, a total of 45 cases of newly diagnosed MM patients, 22 patients received chemotherapy DVDT(Pegylated liposomal doxorubicin 20mg/m2/d1, vincristine 2mg/d1, dexamethasone 40 mg / d1 ~ 4, thalidomide 100 mg / d1‐28), 23 cases accepted VADT chemotherapy(doxorubicin 10mg/d1 ~ 4, vincristine 0.5mg/d1‐4, dexamethasone 40mg/d1 ~ 4, thalidomide 100mg/d1‐28); All patients every 28 days a course of treatment, Three courses of treatment per patient after treatment to assess the analysis above; Check the blood of patients before and after treatment, If the WBC ≤1.5×109/L or neutrophils ≤0.5×109/L, granulocyte colony‐stimulating factor 400U/d intravenously;If the hemoglobin <60g/L or obvious symptoms of anemia, transfusion of packed red blood cells and subcutaneous erythropoietin; If bleeding tendency or platelets ≤10×109/L, the infusion of platelets; For the period of treatment associated with lung or other soft tissue infection, Selective empiric antibiotic anti‐infective therapy; all patients were followed up until March 2014.Results All patients after 3 or more cycles of treatment of myeloma cells, peripheral blood M protein, β2‐ microglobulin, erythrocyte sedimentation rate decreased etc, before and after treatment difference was statistically significant(P <0.001); DVDT chemotherapy group and VADT groups had similar overall efficiency(81.8% more than 73.8%, P = 0.780); Two groups of patients with renal insufficiency 2 weeks from the start of chemotherapy,DVDT patients decreased creatinine ratio was significantly higher than VADT group(P <0.002); DVDT group VADT group Ⅲ ~ Ⅳ degree hematologic adverse reactions: WBC decrease [22.7%(5/22) VS 60.9%(14/23)], HB decline [18.2%(4/22) VS 52.2%(12/23)], PLT decrease [18.2%(4/22) VS 56.5%(13/23)], the differences were statistically significant(P <0.05); DVDT Group VADT group of cardiac toxicity was [13.6%(3/22) VS 52.2%(12/23)], the difference was statistically significant(P <0.05); DVDT group and VADT patients agranulocytosis caused due to infection, infection rates were [18.2%(4/22) VS 47.8%(11/23)], the difference was statistically significant(χ2 = 4.447, P = 0.035).DVDT group and VADT patients because of cardiac function during the treatment failure, infection, bone marrow suppression and other reasons require prolonged hospitalization [9.1%(2/22) VS 39.1%(9/23)], the difference was statistically significant(χ2 = 5.494, P = 0.019).Conclusion Pegylated liposomal doxorubicin for patients with newly diagnosed multiple myeloma treatment efficiency and safety are good, Well tolerated in patients, a low incidence of serious adverse reactions, especially significant improvement in bone marrow suppression and cardiac toxicity aspects, For patients with renal insufficiency may be able to quickly and effectively reduce creatinine levels at its early stage.