Bortezomib-based regimen for the treatment of 110 multiple myeloma patients

Abstract

To analyze the outcomes and adverse effects of bortezomib-based regimen for the treatment of multiple myeloma (MM) patients. A total of 110 MM patients were treated with a bortezomib-based regimen at our hospital from January 2006 to February 2010. The patients over 65 years old received bortezomib-prednisone ± thalidomide (PD±T) regimen or velcade-melphalan-prednisone (VMP) regimen therapy and the patients under 65 years old or resistant to PD±T regimen received bortezomib-doxorubicin-prednisone ± thalidomide (PAD±T) regimen therapy. The outcomes and adverse effects of bortezomib-based regimen were retrospectively evaluated. There were 47 newly-diagnosed MM patients and 63 relapsing/refractory MM patients. The overall remission (OR) rate was 76.4% (84/110) and the OR rate of newly-diagnosed MM patients was statistically higher than that of relapsing/refractory MM patients (83.0% vs 71.4%, P<0.05). The complete remission (CR)+very good partial remission (VGPR) rate in group bortezomib 1.0 mg/m2 was lower than that in group bortezomib 1.3 mg/m2 (newly-diagnosed 53.6% vs 73.7%, relapsing/refractory 28.9% vs 40.0%, both P<0.05). The OR rate of ISS III stage patients was as better as that of ISS I and II stage patients (newly-diagnosed 82.1% vs 83.6%, relapsing/refractory 69.2% vs 72.2%, both P>0.05). Thirteen newly-diagnosed MM patients underwent autologous stem cell transplantation (ASCT) after induced therapy and achieved a VGPR or above. The median follow-up time was 13.0 (6.0-20.0) months. Their conditions were stable except two patients with extramedullary plasmacytoma after ASCT. Thirteen relapsing/refractory MM patients were retreated with a bortezomib-based regimen. The CR rate was 15.4% (2/13), VGPR rate was 23.1% (3/13), partial remission (PR) rate was 23.1% (3/13), OR rate 61.5% (8/13) and the median duration of remission (DOR) was 6.7 (3.0-21.0) months. Six MM patients with extramedullary plasmacytoma were treated with a bortezomib-based regimen and all of them achieved a PR or above. The median DOR was 4.5 (2.0-10.0) months. The main adverse effects were peripheral neuropathy, thrombocytopenia, neutropenia, fatigue, gastrointestinal symptoms, anemia, etc. The bortezomib-based combination regimen is the front-line therapy for newly-diagnosed and relapsing/refractory MM patients.