Clinical Study Of Pomalidomide Plus Cyclophosphamide And Dexamethasone In The Treatment Of Relapsed And Refractory Multiple Myeloma

Objective:To investigate the clinical efficacy and safety of pomalidomide plus cyclophosphamide and dexamethasone(PCD)in the treatment of relapsed and refractory multiple myeloma(RRMM).Methods:The Clinical data of 49 patients with RRMM in the Department of Hematology,the Second People’s Hospital of Lianyungang Affiliated to Bengbu Medical College from March 2021 to June 2022 were collected,including 20 patients in the PCD group and 29 patients in the other group,the regimens were DECP(dexamethasone+etoposide+cyclophosphamide+cisplatin,n=13)and VCD(bortezomib+cyclophosphamide+dexamethasone,n=16).The efficacy and adverse effects were observed after 4 cycles.Results:After 4 cycles of treatment,the overall response rates(ORR)and the clinical benefit rates(CBR)of 20 patients in PCD group were 70.0%(14/20)and 85.0%(17/20),there were 5 cases of CR,4 cases of VGPR,5 cases of PR,3 cases of MR,2 cases of SD,1 cases of PD.The overall response rates(ORR)and the clinical benefit rates(CBR)of 29 patients in control group were 41.4%(12/29)and 65.5%(19/29),there were 2 cases of CR,3 cases of VGPR,7 cases of PR,7 cases of MR,7 cases of SD,5 cases of PD.There were significant difference in ORR(X~2=3.893,P=0.048)and achieved VGPR(X~2=4.469,P=0.035)between the two groups,no significant difference was observed in CBR(X~2=2.305,P=0.129)and achieved CR(P=0.105)between the two groups.There were 2 and 1 patients with renal impairment achieved CR(P=0.152)in the two groups.There were 1 and 0 cases of genetic high-risk patients achieved CR in the two groups,with no statistical significance(P>0.05).The common hematologic adverse effects in the two groups were anemia,neutropenia and thrombocytopenia,and the common non-hematologic adverse effects were malaise,infection and fatigue,respectively,the incidence of grade 3～4 infection in the PCD group was 25.0%(5/20),which were all controlled after anti-infection treatment.The incidence of grade 3～4 infection in control group was 24.1%(7/29),with no statistical significance(P>0.05).Conclusion:PCD regimen have good clinical efficacy and safety in the treatment of RRMM,adverse reactions were generally controllable,and can be considered as a new treatment regimen for Chinese patients.