Wang W X, Bi J Y, Wen L, Duan W B, Liu Y, Wang F R, He Q, Lu J
Department of Hematology, Peking University People's Hospital & Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China.
Department of Hematology, Peking University People's Hospital & Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China Collaborative Innovation Center of Hematology, Suzhou 215006, China.
Zhonghua Nei Ke Za Zhi. 2022 May 1;61(5):531-536. doi: 10.3760/cma.j.cn112138-20211105-00776.
To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM). A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People's Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis. The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively (=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively (=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.
探讨来那度胺联合硼替佐米及地塞米松(RVD)方案治疗初诊多发性骨髓瘤(NDMM)患者的疗效及安全性。回顾性分析2016年8月至2020年9月于北京大学人民医院接受RVD方案治疗的100例连续NDMM患者,内容包括疗效、药物毒性、随访及生存情况,并进行亚组分析。中位随访时间为19.5(2.0 - 57.0)个月。接受RVD方案后行自体干细胞移植(ASCT)的患者,客观缓解率(ORR)/完全缓解+严格完全缓解(CR + sCR)/≥非常好的部分缓解(VGPR)率分别为100%、73.3%(33/45)、95.6%(43/45)。54例未接受移植的患者,ORR/CR + sCR/≥VGPR率分别为79.6%(43/54)、18.5%(10/54)、51.9%(28/54)。生存分析显示,移植组和非移植组患者的2年无进展生存率(PFS)分别为84.5%和70.9%(P = 0.102)。移植组和非移植组患者的2年总生存率(OS)分别为100%和80.8%(P = 0.003)。常见血液学不良事件(AE)为血小板减少(33%)和中性粒细胞减少(25%)。肝功能异常(43%)和周围神经病变(24%)更多被视为非血液学AE。RVD作为一线方案在中国初诊MM患者中具有高效的缓解率及可接受的安全性。