The Clinical Study of Combination of Bortezomib and Dexamethasone in Treatment of Newly Diagnosed Multiple Myeloma

OBJECTIVE: To study retrospectively the response and side effects in two groups of patients with newly diagnosed multiple myeloma (MM) receiving bortezomib and dexamethasone regimen (VD) and vincristine combined with pirarubicin and dexamethasone and melphalan regimen (VADM).

METHODS: Nineteen patients were enrolled in a group of VD, receiving bortezomib 1.3mg/m² on days 1,4,8,11 and dexamethasone 20mg on days 1–4 in a 21-day cycle. Blade Standard was used to evaluate the therapeutic effect and NCI-CTC was used to assess the adverse effect. Thirty-one matched patients with newly diagnosed MM who received VADM were used as a historical control group, receiving vincristine 0.4mg/d and pirarubicin 9mg•m⁻²•d⁻¹ and dexamethasone 20mg/d and melphalan 12mg/d on days 1–4, with 28 days as a cycle.

RESULTS: During the median 9 months’ follow-up of patients who received VD, there were 73.7% patients(14/19)responding to the treatment, including 9 cases (47.4%) of complete remission or near complete remission. Light-chain type patients who received VD had a higher overall response rate and CR +nCR rate than that of the VADM (P<0.05). The patients receiving VD who had renal inadequacy had an effective rate of 69.6% (5/6), which was similar to that of the others (69.2%, 9/13), and renal function relieve could be shown in the chemotherapy. The main adverse effects were fatigue, diarrhea, peripheral neuropathy, thrombocytopenia, and infection, with incidences of 73.8%, 68.4%, 63.2%, 31.5% and 26.3% respectively. Most of the adverse effects were mild and could be relieved by symptomatic treatments. The most common adverse event in the control group was neutropenia (83.8%), followed by infection(35.5%), vomiting (35.5%) and loss of hair(32.5%).

CONCLUSION: Although there was no significant difference of overall response rate between VD and VADM, VD has higher CR +nCR rate compared with VADM. VD can be tolerant in most patients, and is also safe in patients with renal inadequacy.