Efficacy And Safety Of Bortezomib-based Induction Treatment For Multiple Myeloma

Objective: To evaluate the efficacy and safety of BD(bortezomib plus dexamethasone)in the treatment of patients with newly diagnosed multiple myeloma.Methods: Totally 125 patients with multiple myeloma were amlysed tetrospeclively and were divided into three groups according to their treatment protocols:BD group(48 cases),DVD group(22 cases),VAD group(55 cases),who recieved at least 4 courses of treatment.IMWG standard and the NCI-CTCAE3.0 version standard judgment were used to assess the clinical therapeutic effect and adverse reaction in 3 groups,following up for 6 months at least.To evaluate the efficacy and safety of BD(bortezomib plus dexamethasone),DVD(pegylated liposomal Doxorubicin plus Vincristine Plus dexamethasone)and VAD(Vincristine Plus Doxorubicin Plus Dexamethasone)in the treatment of patients with multiple myeloma.Results: After 2 courses,in BD group,≥PR was 50%,CR/s CR was 10.4%,in DVD group,≥PR was9.1%,and CR/s CR was 0%,in VAD group,≥PR was 5.5%,and CR/s CR was0%(P < 0.05);after 4 courses,in BD group,≥PR was 77.1%,and CR/s CR was 27.1%,in DVD group,≥PR was 22.7%,and CR/s CR was 0%,in VAD group,≥PR was20%,and CR/s CR was 1.8%(P < 0.05).The time to CR/s CR of BD group was 3.41 periods,5.3periods in DVD group,5.6periods in VAD group(P < 0.05).The median progression free survival(PFS)after retreatment for group BD,DVD and VAD was 16(4-54),7(3-12)and 8(1-56)months,respectively.In myeloma patients with renal impairment,the renal complete response rate was 50% in the BD group and 11.1% in the DVD group and 0% in the VAD group(P<0.05)。Adverse events such as hematology toxicity reaction of 1 to 3 grade,fatigue,gastrointestinal symptoms,herpes zoster,etc.can relief after symptomatic treatment,peripheral neuropathy can relief mostly by adjusting dosage.Conclusion: BD regimen is demonstrated a rapider onset,a higher response rate,improvement renal function in patients with newly diagnosed MM,with no more adverse events than DVD regimen and VAD regimen.BD regimen can be widely used in the first-line therapy for multiple myeloma.