O2-4-5 - Bortezomib Combined Chemotherapy for Multiple Myeloma Patients Who are Candidate for Autologous Stem Cell Transplant

Abstract

Background: Novel agents for multiple myeloma (MM) have been reported to increase complete remission (CR) rates compared with conventional chemotherapy. It is also estimated that deeper remission may improve survival in MM patients. We retrospectively evaluated the efficacy of novel agents combined induction chemotherapy to treat MM patients who are candidate for autologous stem cell transplant (ASCT).Patients and methods: Thirty seven newly diagnosed MM patients who underwent ASCT at our hospital from April 2004 to September 2012 were retrospectively analyzed. The 20 patients who underwent ASCT before July 2009 were treated with conventional induction Chemotherapy: doxorubicin, vincristine, dexamethasone (VAD) or cyclophosphamide plus VAD (C-VAD), and the recent 17 patients were treated with bortezomib and dexamethasone (BD) followed by ASCT.Results: The median age of patients were 61yr (range: 46-70). The median follow up time was 1041 days (range: 25-2804). There were no significant differences in the patient characteristics between those two groups other than the year of transplant. CR rate was significantly higher in BD group compared with conventional treatment group (56.3% vs. 15.0%, p < 0.001). The two-year overall survival is significantly improved in BD group and compared to VAD/C-VAD group (100% vs. 70% p = 005). The same trend is observed in two-year progression free survival (87.5% in BD group vs. 45.0% in VAD/C-VAD group), though it was not statistically significant (p = 0.17). In multivariate analysis, also, BD induction chemotherapy significantly improved CR rate (Odds ratio = 24.1, p < 0.01).Conclusion: Bortezomib combined induction chemotherapy for MM may improve survival by achieving deeper remission in ASCT setting.