Wu Shenghao, Zheng Cuiping, Chen Songyan, Cai Xiaoping, Shi Yuejian, Lin Bijing, Chen Yuemiao
Department of Hematology, Wenzhou Central Hospital, Dingli Clinical College of Wenzhou Medical University, Zhejiang 32500, China.
Biomed Res Int. 2015;2015:927105. doi: 10.1155/2015/927105. Epub 2015 Sep 6.
To investigate the efficacy and safety of the treatment of the newly diagnosed multiple myeloma (MM) patients with the therapy of subcutaneous (subQ) administration of bortezomib and dexamethasone plus thalidomide (VTD) regimen.
A total of 60 newly diagnosed MM patients were analyzed. 30 patients received improved VTD regimen (improved VTD group) with the subQ injection of bortezomib and the other 30 patients received conventional VTD regimen (VTD group).The efficacy and safety of two groups were analyzed retrospectively.
The overall remission (OR) after eight cycles of treatment was 73.3% in the VTD group and 76.7% in the improved VTD group (P > 0.05). No significant differences in time to 1-year estimate of overall survival (72% versus 75%, P = 0.848) and progression-free survival (median 22 months versus 25 months; P = 0.725) between two groups. The main toxicities related to therapy were leukopenia, neutropenia, thrombocytopenia, asthenia, fatigue, and renal and urinary disorders. Grade 3 and higher adverse events were significantly less common in the improved VTD group (50%) than VTD group (80%, P = 0.015).
The improved VTD regimen by changing bortezomib from intravenous administration to subcutaneous injection has noninferior efficacy to standard VTD regimen, with an improved safety profile and reduced adverse events.
探讨皮下注射硼替佐米、地塞米松联合沙利度胺（VTD）方案治疗新诊断的多发性骨髓瘤（MM）患者的疗效和安全性。
共分析60例新诊断的MM患者。30例患者接受改良VTD方案（改良VTD组），皮下注射硼替佐米，另外30例患者接受传统VTD方案（VTD组）。对两组的疗效和安全性进行回顾性分析。
治疗8个周期后的总缓解率（OR）在VTD组为73.3%，在改良VTD组为76.7%（P>0.05）。两组之间1年总生存率估计时间（72%对75%，P = 0.848）和无进展生存期（中位22个月对25个月；P = 0.725）无显著差异。与治疗相关的主要毒性为白细胞减少、中性粒细胞减少、血小板减少、乏力、疲劳以及肾脏和泌尿系统疾病。改良VTD组3级及以上不良事件的发生率（50%）显著低于VTD组（80%，P = 0.015）。
将硼替佐米从静脉注射改为皮下注射的改良VTD方案与标准VTD方案疗效相当，安全性提高，不良事件减少。
