Clinical research of bortezomib based chemotherapeutic regimen for multiple myeloma

Abstract

Objective To research the curative effect and adverse reactions of bortezomib in the treatment of newly diagnosed and relapsed or refractory multiple myeloma(MM).Methods Thirty-two patients including 21 newly diagnosed multiple myeloma patients and 11 relapsed or refractory multiple myeloma(RRMM)patients.Twenty-one patients were treated with BTD regimen,it consisted of bortezomib(1.0-1.3 mg/m2) by rapid intravenous injection on the 1 st,4 th,8 th and 11th day,and dexamethasone 20 mg/d by intravenous drip(day 1-4) or 10 mg/d by intravenous drip(day 1-4,day 9-12,day 17-20),and oral thalidomide (100-200 mg/d) was given for the whole course.Nine patients received BD regimen,usage as same as the former.Two patients were treated with PAD regimen,adriamycin(9 mg/m2) was used on dayl-4,other usage as same as the former.All regimen were repeated,every 21 days as one cycle.Response to Bortezommib was assessed according to the criteria of European Group for Blood and Marrow Transplantation,and adverse reaction were evaluated according to the criteria of National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0.The prognosis factors were analysed by chi-square test and Spearman rank correlation.Results The total clinical response(CR + nCR + PR + MR) was 90.6％,newly diagnosed patients compared with RRMM patients,the difference was significant (P =0.27).The total better response (CR + nCR + PR) was 71.8 ％,compared the two groups,the difference was significant (P =0.04).The total complete response (CR) was 71.8％,the difference was significant between the two groups (P =0.12).The total near complete response(CR + nCR) was 56.2％,the difference was significant between the two groups (P =0.03).The correlation coefficient of course and remission level was 0.60,the difference was significant (P ＜ 0.01).The major adverse events during treatment were blood hypocellular(56％),gastrointestinal disorder (49％),peripheral neuropathy (32％),systemic symptom (27％).Three patients got herpes zoster and one got rash.Conclusions Bortezomib based chemotherapy was well tolerated and effective in treatment of multiple myeloma,even newly diagnosed or RRMM patients. Key words: Bortezomib ; Multiple myeloma; Efficacy ; Adverse events