Chemotherapy In The Treatment Of Multiple Myeloma 26 Cases With Combined Bortezomib And Dexamethasone

ForewordMultiple myeloma is characterised by excess bone marrow plasma cells, monoclonal protein, osteolytic bone lesions,renal disease, and immuno defi ciency. The disease causes about 1% of neoplastic diseases and 13% of haematological malignancies. The incidence varies globally from 1 per 100 000 people in China, to about 4 per 100 000 people in most developed countries. Complete remission rate after conventional treatments,such as VAD(vincristine+doxorubicin+dexamethasone) M2 (Carmustine+Melphalan+prednisone+vincristine+cyclophosphamide) treatments is about 3%～10%, The median overall survival si 3-4 years.High-dose treatment followed by autologous stem-cell transplantation can extend the median survival. The median disease-free survival and Overall survival is 39.0 Months and 64.6 Months1. An other report says this Method can extended the median survival to 5-7 years2。The boronic dipeptide bortezomib, Trade named Velcade, is a first-in-class proteasome inhibitor,was first Approved to treatment multiple myeloma by U.S. Food and Drug Administration (FDA) in May 2003 and showed a Significant effect3. The history of brought bortezomib in clinical and used it for multiple myeloma treatment is about 5 years. With the application of time, bortezomib was extended continuously. Accompanied with is, drug suing experience accumulatde.A lot of reports suggested that bortezomib had a significant effect in treatment of multiple myeloma in out country. This study uses bortezomib for the treatment of multiple myeloma in 26 patients to evaluate the efficacy, analysis the similarities and differences in patients with different types, observed the side effects. The conclusions will used to guide clinical treatment strategies and for related research. ObjectiveObserved the Efficacy and side effects in the treatment of multiple myeloma with bortezomib combined dexamethasone.Methods26 cases of multiple myeloma patients receiving bortezomib combined dexamethasone in the treatment. All patients received at least one course of chemotherapy in this program. At the same time received adjuvant therapy.Evaluate the therapeutic effect and adverse reaction.Result26 patients completed 2.5 (1-8) courses of treatment, of which 19 cases were response(CR+PR).The response rate is 79.2%(58%-93%, P=0.05).11 cases of CR patients completed a median 3 (1-8) courses of chemotherapy, the CR rate is 45.8% (26%-67%, P=0.05).14 newly diagnosed patients completed 3 (1-8) courses of treatment,12 cases were response,the response rate is 92.3%(68%-100%, P=0.05). Of which 7 cases were CR,the CR rate is 53.8%(25%-81%, P=0.05).ConclusionThe chemotherapy of using bortezomib combined dexamethasone for multiple myeloma has a fast response and a high response rate and the side effects can be controlled. It is safe and effective in patients with renal insufficiency. And this program enables the patient to complete remission as soon as possible, especially for newly diagnosed patients with light chain. Newly diagnosed patients need complete at least 2 course of standard treatment for further evaluation.