| Objective: To evaluate the effficacy and safety of bortezomib-dexamethasone-thalidomide in the treatment of autologous stem cell transplantation in multiple myeloma.Methods: The randomized controlled trials(RCT)of bortezomib-dexamethasone-thalidomide in the treatment of autologous stem cell transplantation in multiple myeloma in English database the Cochrane Library?Pubmed?Medline and Chinese database CNKI?VIP and Wanfang database from the establishment to December 2015 were retrieved.The included RCTs were performed the quality evaluation according to the methods of the Cochrane systematic review and trials were performed the meta analysis by using the Review Manager 5.3.5 software.Results: Five RCTs involving 1271 patients were included.The meta analysis results showed that compared with other combination therapies,bortezomib-dexamethasone-thalidomide had significant higer in the CR/n CR rate [RR= 1.85,95%CI(1.16,2.96),P=0.009] and overall response rate [RR= 1.21,95%CI(1.03,1.42),P=0.02] when compared with TD,but lower in the PR rate when compared with TD or VD,and the VGPR rate,1 year PFS rate,2 year PFS rate,and 3 year PFS rate were not different.However,thrombocytopenia [RR=2.07,95%CI(1.15,3.72),P=0.01],gastrointestinalevents [RR=3.34,95%CI(1.25,8.94),P=0.02],peripheral neuropathy [RR=2.62,95%CI(1.77,3.88),P<0.00001] were recorded in a significiantly higher number of patients on VTD than in those onTD,and had no difference in other adverse events including anemia,constipation,fatigue,infection.When compared with VD or VDTC,VTD decreased the incidence of peripheral neuropathy [RR=0.27,95%CI(0.08,0.94),P=0.04],and other adverse events were not different.Conclusion: VTD in the treatment of autologous stem cell transplantation in multiple myeloma have significant therapy value in improving the CR/nCR and ORR when compared with TD,but increase the incidence of the adverse events in thrombocytopenia,gastrointestinal and peripheral neuropathy. |
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