Clinical observation of bortezomib plus dexamethasone regimen for patients with light-chain multiple myeloma / 肿瘤研究与临床

ABSTRACT

Objective To comparatively analyze the efficiency and toxicity of BD (bortezomib plus dexamethasone) regimen and VAD (vincristine combined with pirarubicin and dexamethasone) regimen for patients with light-chain multiple myeloma (MM).Methods Retrospective investigation of 16 cases of patients with light-chain MM.7 patients were receiving BD regimen and 9 patients were receiving VAD regimen.Results With a median follow-up of 24 months (2-76 months) in BD group,the total response rate (85.7 ％,6/7) was higher than VAD group (55.6 ％,5/9),with no statistical significance (x2 =1.667,P =0.308).But the CR+nCR rate of the BD group (42.9 ％,3/7) was significantly higher than VAD group (0.0 ％,0/9) (x2 =4.747,P =0.029).5 patients with renal dysfunction in BD group,and that of total response rate (80.0 ％,4/5) was higher than VAD group (57.1％,4/7),but with no statistical significance (x2 =0.686,P =0.576).Main adverse effects in BD group were hematologic toxicity combined with infection (42.8 ％,3/7),peripheral neuropathy (28.6 ％,2/7) and digestive reaction (14.3 ％,1/7).These adverse effects were mild (grade 1-2) and could be relieved by symptomatic treatments.The most common adverse events in VAD group were hematologic toxicity combined with infection (44.4 ％,4/9),digestive reaction (33.3 ％,3/9) and hair loss (22.2 ％,2/9).Conclusion Light chain MM has an aggressive clinical course with poor response to treatment and unfavorable prognosis,but BD regimen has significantly improve the overall reaction rate of light chain type MM.BD has higher CR+nCR rate compared with VAD and can be tolerant in most patients.BD is safe in patients with renal inadequacy.