Ciftciler Rafiye, Goker Hakan, Buyukasik Yahya, Sayınalp Nilgun, Haznedaroglu Ibrahim C, Aksu Salih, Ozcebe Osman, Demiroglu Haluk
Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Hematol Rep. 2020 May 6;12(1):8267. doi: 10.4081/hr.2020.8267.
The treatment landscape and clinical outcome of multiple myeloma (MM) patients have changed in the last decades, with an improved median survival of 8-10 years. This study aimed to evaluate the bortezomib, cyclophosphamide and dexamethasone (VCD) regimen bortezomib and dexamethasone (VD) regimen in patients with newly diagnosed MM. This study has been performed in a retrospective manner. One hundred and three patients with newly diagnosed MM who received chemotherapy at our tertiary care center between the years of 2009 and 2018 were evaluated. A total of 103 patients were included. The 5-year overall survival (OS) for patients who received VD regimen and patients who received VCD regimen were 75% and 83%, respectively. The OS for VD patients was 113.1±12.5 122.2±9.5 months for VCD patients with no statistically significant difference (P=0.47). The 5- year PFS (progression free survival) for patients who received VD regimen and patients who received VCD regimen were 66% and 75%, respectively. The PFS for VCD patients was higher than the PFS for VD patients (67.1±7.4 97.7±13.4 months), but no statistically significant difference was observed (P=0.59). Relapse rate (P=0.002) and mortality rate (P=0.01) were higher in VD group than VCD group and they were statistically significant. The OS and PFS were clinically longer in patients receiving VCD regimen than in patients receiving VD regimen, although not statistically significant. Cyclophosphamide should be given to patients at physician discretion and depending on patient's frailty function.
在过去几十年中,多发性骨髓瘤(MM)患者的治疗格局和临床结局发生了变化,中位生存期提高到了8至10年。本研究旨在评估硼替佐米、环磷酰胺和地塞米松(VCD)方案以及硼替佐米和地塞米松(VD)方案用于新诊断MM患者的情况。本研究采用回顾性研究方法。对2009年至2018年间在我们三级医疗中心接受化疗的103例新诊断MM患者进行了评估。共纳入103例患者。接受VD方案的患者和接受VCD方案的患者的5年总生存期(OS)分别为75%和83%。VD组患者的OS为113.1±12.5个月,VCD组患者为122.2±9.5个月,差异无统计学意义(P=0.47)。接受VD方案的患者和接受VCD方案的患者的5年无进展生存期(PFS)分别为66%和75%。VCD组患者的PFS高于VD组患者(67.1±7.4个月对97.7±13.4个月),但差异无统计学意义(P=0.59)。VD组的复发率(P=0.002)和死亡率(P=0.01)高于VCD组,且具有统计学意义。接受VCD方案的患者的OS和PFS在临床上比接受VD方案的患者更长,尽管差异无统计学意义。环磷酰胺应根据医生的判断并取决于患者的虚弱状况给予患者。