Hematological and Biochemical Changes in Patients with Multiple Myeloma Treated with Bortezomib Based Triple Drug Combination Chemotherapy

Abstract

Background: Multiple Myeloma (MM) is a neoplastic clonal disorder and accounts for 1% of malignant tumors and 10%–15% of hematopoietic neoplasms. The prognosis of Multiple Myeloma has reversed by the advent of novel agents and triple combination therapy (Bortezomib, Thalidomide, Dexamethasone) that serve the basis of future strands of care in Multiple Myeloma patients. Objective: The aim of the study was to assess the safety, efficacy and tolerability of Bortezomib in newly diagnosed cases of Multiple Myeloma patients in Bangladesh. Materials &Methods: We undertook this clinicopathological study to assess the profile of Multiple Myeloma patients, evaluate hematological and biochemical response of 36 newly diagnosed cases of MM with or without renal impairment receiving 4 cycles of Bortezomib, Thalidomide and Dexamethasone (BTD). Results: Among the study population, 36(100%) patients had weakness. followed by anaemia (97%), bone pain (89%) and renal impairment (44%). During treatment, 8 patients (22%) suffered from somnolence, 5 patients (14%) had Peripheral neuropathy and 6 (17%) patients complained of constipation. We found 8% suffered from hyperglycaemia, 3% rash, 3% cardiac arrest, 6% electrolyte imbalance and life threatening intracranial haemorrhage occurred in 1 patient (3%). Out of 36 patients, complete response achieved in 18 patients (50%), where 6 patients (16%) showed partial response, 10 (28%) showed very good partial response and 2 (6%) patients showed no response. The overall response rate was 94% belonged to complete response(CR), Partial response(PR),very good partial response(VGPR). Conclusion: Bortezomib based combination therapy is a highly effective and safe regimen for newly diagnosed Multiple Myeloma patients. . It can be administered safely in the outpatient setting provided by clinicians.