Efficacy of PAD regimen and VAD-like T regimen in the treatment of newly diagnosed multiple myeloma:a comparative study of 126 cases / 白血病·淋巴瘤

ABSTRACT

Objective To evaluate the efficacy of PAD regimen (bortezomib, doxorubicin, dexamethasone) and VAD-like T regimen (vincristine, doxorubicin/doxorubicin derivatives, dexamethasone combined with thalidomide) in the treatment of patients with newly diagnosed multiple myeloma (MM). Methods The efficacy of 54 patients with MM who received VAD like-T regimen and 72 patients with MM who were treated with PAD regimen, including complete remission (CR) rate, very good partial remission (VGPR) rate, overall response rate (ORR), overall survival (OS), progression-free survival (PFS) and adverse events, were retrospectively analyzed. Results The CR rate of PAD group was higher than that of VAD-like T group [31.5 % (23/72) vs. 9.3 % (5/54), χ2=0.30, P=0.002]. The VGPR rate and ORR of PAD group were not statistically higher than those of VAD-like T group [16.7 % (12/72) vs. 16.6 % (9/54), P=0.180; 82.2 %(65/72) vs. 81.5 % (44/54), P=0.190, respectively]. Median PFS of PAD group was significant longer than that of VAD-like T group [(38.2±2.2) months vs. (28.0±7.6) months, P=0.017]. The 3- and 5-year OS rates of PAD group were higher than those of VAD-like T group, but there were no significant differences between two groups (P>0.05). In terms of the adverse events, the incidence of peripheral neuropathy in PAD group was significantly higher than that of VAD-like T group [31.5 % (23/72) vs. 14.5 % (8/54), P=0.03]. Conclusions Compared with PAD protocol, the CR and median PFS of VAD-like T regimen are poor, however, VGPR,ORR, PFS and 5-year OS are similar between the two groups, and VAD-like T regimen is safer with low incidence of peripheral neuropathy. VAD-like T regimen as the first-line treatment is effective and well-tolerated, especially for newly diagnosed MM patients not suitable for transplantation and bortezomib.