Clinical Analysis Of VAD, MPT And VD Regimen With In Untreated Multiple Myeloma

Baekground: Multiple myeloma is a bone marrow monoclonal plasma cell hyperplasiaand is characterized by hematopoietic malignancies, the incidence increased year by year,more than acute leukemia, non-Hodgkin’s lymphoma of high incidence of blood systemtumors, accounting for10%of the hematopoietic system tumors, in the elderly prone, with amedian age of onset is about65years old, male to female ratio of approximately3:2. Chinaevery year about14,000cases of newly diagnosed patients with multiple myeloma. Themedian survival of untreated patients with multiple myeloma only six months, chemotherapyis the most basic, the most common treatment, chemotherapy can significantly prolongsurvival. Along with boron for bortezomib, thalidomide, lenalidomide amines and other newdrugs in clinical treatment of multiple myeloma has been a rapid development. How tochoose chemotherapy to improve efficacy and reduce adverse events of great significance.PurPose: Untreated patients with multiple myeloma commonly used in clinicalchemotherapy regimens of the VAD, the MPT, the VD program efficacy and adversereactions of optimize chemotherapy choice.Methods: Application to collect the Affiliated Hospital of Jilin University of VAD, theMPT, the VD program early multiple myeloma treated patients clinical data for efficacyevaluation of the collected123cases of combined therapy in patients with4cycles, parallelage, ISS stage, creatinine stratified further evaluationchemotherapy efficient and completeremission rate. Adverse reactions in all patients during chemotherapy were analyzedstatistically. Application SPSS17.0statistical software for statistical analysis, count data withthe χ~2test, measurement data, the t-test, the experimental data using the mean±standarddeviation, P <0.05prompted difference was statistically significant.Results: Into the group of123cases of previously untreated patients, the line VAD inthe treatment of39cases, the CR5.1%, VGPR15.4%,41%of the PR, ORR61.5%; lineMPT in the treatment of56cases, the CR5.4%, VGPR23.2%, PR35.7%,ORR64.3%; lineof VD in the treatment of28cases, the CR35.7%, VGPR14.3%, PR32.1%, ORR82.1%.Three schemes total effective rate was no significant difference between the VD programcomplete remission rate was significantly higher than that of VAD, the MPT program.Subgroup analysis,①two age subgroups total efficiency of the three options was no significant difference, the complete remission rate of VD program than those of VAD, theMPT program, the young group with the statistical analysis obtained P values were0.028,0.018The older group P values were obtained in the statistical analysis for the0.046,0.048.②of ISS staging subgroup analyzes show ISS stage I of subgroups in the threeoptions in the efficient and complete remission were not statistically different. ISS stage II ofthe subgroup with VAD and MPT and VD program there is always efficient and completeremission were not statistically different, the MPT group and the VD group, the totaleffective rate was no significant difference, but the VD program of complete response ratehigher than the MPT program (P=0.036). ISS stage III of subgroups in the VD groupcompared with the VAD, the MPT group regardless of the total efficiency or completeremission were higher than the VAD, the MPT group. The total statistical analysis of theefficiency of the VD group and the VAD group and MPT obtained P values were for the0.007,0.027; complete remission rate is relatively VD group and statistical analysis of theVAD group and MPT, the P values were0.0390.047.③renal function subgroup analysisderived creatinine greater than2mg/dl subgroup VAD group with the MPT group and the VDgroup no significant difference in the VD group than in the MPT group total effective rate (P=0.032). Creatinine less than2mg/dl group of three options the total effective rate was nosignificant difference. Creatinine greater than2mg/dl subgroup VD group and the VADgroup and MPT group compared the obtained P values were0.039,0.016; creatinine less than2mg/dl subgroup VD group VAD group and MPT group compared The obtained P valueswere0.038,0.016.VD group the total incidence of adverse reactions is lower than the VAD group andMPT group (P=0.027,0.038) obtained after the analysis of adverse reactions afterchemotherapy.3hematologic toxicity in the VAD group compared with VD group (P=0.017). VAD group compared with VD group liver function damage to the high incidence (P=0.017). Peripheral nerve toxicity of VAD group is lower than the MPT group and the VDgroup (P=0.043,0.018). Edema occurs only in the VD group, statistical analysis with theMPT group difference (P=0.034), no significant difference with the VAD group. Thereaction of the rest of the gastrointestinal tract, peripheral neurotoxicity, infection, fatigue,sleepiness were not statistically different after statistical analysis.Conelusion:1、VAD, the MPT, the VD program there is always no difference in efficiency, but thecomplete remission rate of VD program than the MPT program and VAD. 2、The age of65as the boundary of the subgroup analysis, the VD program in differentage groups can get a higher rate of complete remission. ISS stage line in the subgroupanalysis, stage late to benefit the greater of the VD program. Line in the subgroup analysis,regardless of renal function is normal or abnormal VD group have access to a highercomplete remission rate of renal function.3、VD program is a low incidence of adverse reactions compared to the MPT programand VAD.4、VAD group3hematologic toxicity, liver damage than the VD group, a highproportion. However, the incidence of peripheral neurotoxicity VAD group is lower than theMPT group and the VD group.