Effects of bortezomib in combination with cyclophosphamide and dexamethasone in the treatment of multiple myeloma / 实用医学杂志

ABSTRACT

Objective To retrospectively analyze the clinical efficacy and safety of VCD (bortezomib/cyclophosphamide/dexamethason) in the treatment of multiple myeloma (MM) patients. Methods Fifty-five consecutive patients with newly diagnosed or relapsed MM were enrolled in the study retrospectively from June 2012 to June 2017. We collected and analyzed the clinical information of all patients treated with VCD.Results Firstly, the patients received therapy of VCD for median 4 cycles (Range : 2 ～8). The overall response rate (ORR) was 85.5％ (45/55). The complete response/near complete response rate (CR/nCR) , very good partial response rate (VGPR) and partial response rate (PR) were 27.3％, 23.6％ and 34.6％, respectively. The ORR of10 patients with renal inadequacy was 80.0％, while 45 cases with normal renal function was 82.2％ (P=0.627).Secondly, with a median follow-up of 13.5 months, the median progression free survival (PFS) , the median duration of response (DOR) and the median overall survival (OS) were 27 (1～61) months, 18 (1～50) months and 49 (1～64) months, respectively. Univariate prognostic analysis showed that abnormal ISS stage Ⅲ, relapse, renal dysfunction and response inferior to VGPR were negative prognostic factors for PFS, while abnormal ISS stageⅢ and renal dysfunction were negative prognostic factors for OS. Moreover, the multivariate prognostic analysis showed that abnormal ISS stage Ⅲ and response inferior to VGPR were independent prognostic factors for PFS, while ISS stage Ⅲ was independent prognostic factors for OS. Thirdly, the VCD treatment is effective and safe.The adverse events were evaluated according to International Myeloma Working Group Uniform Response Criteria.The results showed that the most common grade 3 ～4 non-hematology adverse events (AEs) were infection (20.0％) , peripheral neuropathy (5.5％) and hypertension (5.5％). The most common grade 3～4 hematology AEs were thrombocytopenia (10.9％) , neutropenia (9.0％) and anemia (5.5％). A total of 2 patients (3.6％) discontinued VCD because of serious peripheral neuropathy and 2 cases (3.65％) died of respiratory failure because of serious infection. Conclusions The VCD regimen is effective and safe in the treatment of newly diagnosed or relapsed/refractory MM patients in China. VCD is safe in patients with renal dysfunction.