The efficacy and safety of PAD and VAD regimens for untreated multiple myeloma / 中华内科杂志

ABSTRACT

Objective To compare the efficacy and adverse effects of bortezomib+adriamycin+dexamethasone (PAD) and vincristine + adriamycin + dexamethasone (VAD) regimens in untreated multiple myeloma (MM). Methods There were 26 and 28 new diagnosed MM patients in PAD and VAD groups. Both clinical effects and adverse effects were observed. Patients accepted VAD or PAD regimens for 2-4 cycles and followed up for 7-27 months. Results There were 10, 5 and 11 patients accepted 2, 3 and 4 cycles in PAD group, and 6, 11 and 11 in VAD group. In PAD group, there were 2, 14, 9, 1 and 0patients achieved complete remission (CR), very good partial remission (VGPR), partial remission (PR),stable disease (SD) and progressive disease (PD); in VAD group, the number were 0, 4, 12, 10 and 2.The rate of patients who achieved good efficacy (CR+VGPR) in PAD group was 61.5%, which was higher than that in VAD group (14.3%).The incidences of infection and gastrointestinal symptoms were similar in the two groups, while the incidences of peripheral neuropathy, thrombosis and Herpes Zoster infection in PAD group were higher than those in VAD group. Conclusions Compared with the conventional VAD chemotherapy, PAD may improve CR and VGPR rates in new diagnosed MM, while it may bring more and severer toxicities in peripheral neuropathy, thrombosis and Herpes Zoster infection. Preventive medical care is necessary in PAD protocol.