Objective: To study retrospectively the response and side effects in two groups of patients with untreated multiple myeloma receiving bortezomib-based regimen (VD/VT) and vincristine combined with adriamycin and dexamethasone (VAD).
Methods: Eighteen patients were enrolled in a group of VD or VT, receiving bortezomib 1.0 mg/m2 or 1.3 mg/m2 on days 1, 4, 8 and 11, along with dexamethasone 20-40 mg on days 1-4 (12 cases); or thalidomide 100 mg/d continuously (6 cases). Twenty-four patients treated with VAD entered into a control group, receiving vincristine 0.4 mg/d on days 1-4, adriamycin 9 mg x m(-2) x d(-1) on days 1-4 and dexamethasone on days 1-4, 9-12, 17-20, with 28 days as a cycle.
Results: After bortezomib-based combinations, 16 of with 18 patients (88.9%) achieved at least a partial response, including complete response and near complete response in 7 patients (38.9%). Side effects in the VD/VT group were predictable and manageable; they were mainly haematologic, gastrointestinal, and peripheral neuropathic and were more evident during early cycles. The main side reactions in the VAD group were infections, loss of hair and phlebitis.
Conclusion: Bortezomib-based combinations therapy is an effective and safe induction regimen for newly diagnosed multiple myeloma patients and appears significantly superior to VAD, yielding high response rates even in patients with poor prognostic features.