[Bortezomib-based induction therapy followed by autologous hematopoietic stem cell transplantation in multiple myeloma]

Beihui Huang, Juan Li, Junru Liu, Jingli Gu, Dong Zheng, Duorong Xu, Waiyi Zou, Hehua Wang
Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine] 2014, 53 (11): 865-72

OBJECTIVE: To evaluate the short-term and long-term effect of novel agents followed by autologous hematopoietic stem cell (ASCT) in Chinese multiple myeloma(MM) patients in order to find out the optimal therapeutic regimen for transplant-eligible patients.

METHODS: Clinical data of 100 active MM patients receiving bortezomib-based induction regimens followed by high-dose melphalan and ASCT were retrospectively analyzed from June 1, 2006 to January 30, 2014.

RESULTS: The overall response rates(ORR) after induction therapy, transplantation and consolidation and maintenance therapy were respectively 90.0%, 97.0%, and 98.9%. The median progress free survival(PFS) was 42.3 months. The median overall survival(OS) was not reached. The cumulative near complete response (nCR)+complete respanse(CR) rate was no longer improved after 4 cycles of induction therapy for non-light chain type MM and two cycles for light-chain type. In newly-diagnosed light-chain type MM patients, the cumulative nCR+CR rate after 4 cycles of bortezomib plus dexamethasone (VD) regimen was similar to that of bortezomib, doxorubicin and dexamethasone (PAD). While for those non-light-chain types, three drug-based regimen was better than two drug-based. PFS of patients receiving early ASCT was longer than that of late ASCT (50.7 months vs 26.6 months, P = 0.023) . PFS in patients receiving autologous bone marrow stem cell transplantation (ABMSCT) was longer than that of autologous peripheral blood stem cell transplantation (APBSCT) (NA vs 36.1 months, P = 0.049) . Maintenance therapy was beneficial regardless of the response rate after ASCT. Patients with CR at any time during the therapy had longer PFS than those with nCR.

CONCLUSIONS: Bortezomib-based therapy followed by ASCT is the first line therapy for transplant-eligible MM patients. Patients with different types of M protein require different induction regimens. Maintenance is beneficial to patients after ASCT, no matter whether a CR is reached or not. Patients with CR after induction or ASCT tend to have longer survival.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"