Abstract:
Objective This study investigated the efficacy and safety of a combination of lenalidomide, bortezomib, and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM).
Methods The clinical features and responses of 48 patients with NDMM who were treated with RVD from January 2015 to May 2019 in Beijing Chaoyang Hospital were retrospectively analyzed.
Results The median age of the 48 patients was 59 years (range:34-79). Among these, 44 patients were Durie-Salmon stage Ⅲ, 15 were ISS stage Ⅱ, 19 were ISS stage Ⅲ, and 12 had plasmacytoma; 32.5% of all patients were cytogenetic high-risk. All patients received a median of four cycles (range:1-9) of the RVD regimen as induction treatment. The overall response rate was 97.9%, with 35.4% of patients achieving complete response (CR) or better. The rate of very good partial remission (VGPR) or better was increased from 64.1% (after two cycles) to 84.6% (after four cycles). The mean collection of CD34+ cells was 4.2 (±2.6)×106/kg. Negative minimal residual disease (MRD), as indicated by next-generation flow (NGF), was achieved in 20.6% of patients after induction. Two patients with positive MRD after induction became MRD negative after transplantation. Two patients developed grade 3 or 4 hematologic toxicity. No nonhematologic toxicity of grade 3 or 4 was observed.
Conclusions In patients with NDMM, RVD treatment resulted in significantly improved response rates and exhibited an acceptable risk-benefit profile, with no adverse impact on stem cell collection. RVD combined with transplantation significantly improved the negative rate of MRD, as indicated by NGF.