Clinical Study Of BDT And VADT On Multiple Myeloma

Objective To compare the efficacy and safety of bortezomib combined with dexamethasone and thalidomide(VDT) and vincristine combined with epirubicin and dexamethasone and thalidomide(VADT) in the treament of multiple myeloma(MM).Methods 72 patients were analyzed retrospectively,24 (newly diagnosed 13, relapsed/refractory 11) of whom were enrolled in a group of VDT,and another 48(newly diagnosed 36,relapsed/refractory 12) patients were treated with VADT.All cases except those gave up and were lost of follow-up were evaluated after 4-6 cycles.Results The total complete remission rate(TR) of VDT was 68.42%, which was significantly higher than that of VADT(35.42%) (P<0.05). Besides, the TR of newly diagnosed cases and relapsed/refractory cases in VDT group was 80% and 55.56% respectivly, both of which was distinctly improved compared with VADT group (P<0.05).There were 89.47% patients responded in VDT group, with no difference in VADT group(70.83%) (P>0.05).The median cycles required to response and to best response in VDT group were significantly shorter than in VADT group. In VDT group, the newly diagnosed patients required 3 median cycles to reach best response and relapsed/refractory patients needed 4 median cycles, both of which were shorter than that in VADT group(5,7). The most common adverse drug reaction(ADR) of VDT and VADT included arrest of bone marrow, gastroenteric reaction, liver damage or renal dysfunction, peripheral neuropathy, fatigue, thrombosis, dysfunction of blood coagulation, herpes zoster, mental symptom and rash. There were no positive statistical correlation of ADR between the two group.Conclusion VDT has higher TR rate and shows obvious effects on MM compared with VADT, especially on relapsed/refractory patients. It has quick action and can be tolerant in most patients, and to be worth generalization at clinical.