Abstract:
Objective To compare the efficacy and adverse effects of bortezomib+cyclophosphamide+dexamethasone (PCD) and vincristine+adriamycin+dexamethasone (VAD) regimens in multiple myeloma (MM).
Methods A total of 41 patients with MM were analyzed retrospectively and divided into two groups according to their treatment protocols: PCD group (21 cases) and VAD group (20 cases). Clinical effects and adverse effects were observed in both groups. Patients accepted two to four cycles of PCD or VAD regimens.
Results In the PCD group, three patients achieved complete remission (CR), three patients had very good partial remission (VGPR), three patients were under partial remission (PR), eight patients had stable disease status (SD), and four patients had progressive disease (PD). In the VAD group, none achieved CR, one patient had VGPR, two patients were under PR, nine patients had SD status, and nine patients had PD. The rate of patients who achieved efficacy (CR+VGPR+PR) in the PCD group was 42.9%, which was higher than that of the VAD group (15.0%). The rate of newly diagnosed patients who achieved good efficacy (CR+VGPR) in the PCD group was 50%, which was higher than that of the VAD group (7.7%). The incidence of herpes infection, cytopenia, fatigue, and gastrointestinal symptoms was similar in the two groups, whereas the incidence of neurotoxicity in the PCD group was higher than that of the VAD group.
Conclusion The response rate of PCD is higher compared with that of conventional VAD chemotherapy, especially in newly diagnosed MM. PCD may improve CR and VGPR rates and may bring about more severe toxicities, such as neuropathy.