The Clinical Comparative Analysis Of Multiple Myeloma Treated With T-VAD And T-VD Regimen

ObjectiveBy collecting clinical data, to review the clinical manifestations and laboratory examination results of newly diagnosed multiple myeloma. And compare the effects and side-effects in patients with multiple myeloma who treated with T-VAD regimen and T-VD regimen. After the novel agency applied, such as thalidomide and bortezomib, the life quality of patients improved. Combined chemotherapy have better therapeutic effect. Through comparing the effects and side-effects of the two common regimens which were T-VAD and T-VD in our hospital, we try to direct the clinical practice.Methods74newly diagonsed multiple myeloma patients were selected in this study. We collected the following information of patients:sex、age、serum protein electrophoresis、immunofixation electrophoresis、serum free light chain、 albumin、β-2microglobulin、urea nitrogen、creatinine. There are forty patients in the group of T-VAD,in which male eighteen, female twenty two, type IgA ten, type IgG eighteen, type IgD one, light chain eleven, non-secreted zero; stage Ⅰ four, stage Ⅱ sixteen, stage Ⅲ twenty. There are thirty four patients in the group of T-VD, in which male seventeen, female seventeen, type IgA seven, type IgG fourteen, type IgD two, light chain ten, classification unknowned one; stage Ⅰ six, stage Ⅱ eight, stage Ⅲ twenty. Thus we review these74newly diagnosed multiple myeloma patients and then analysing them by t-test.ResultsIn these74newly diagnosed multiple myeloma patients,there are25complicated with renal failure,50suffered bone pain,48have different degree of anemia, and hypercalcemia was found in no one patients. In T-VAD group,18patients reached remission (3got CR and15achieved PR). And In T-VD group27reached remission (9patients achieved CR and18reached PR) Through T-test there are significant differences between the two groups. Then we analyzed the influence of renal function、disease type and stage on efficacy. Whatever in the renal insufficiency group or not, and what type the disease is, the efficacy always better in T-VD group than in T-VAD group (p=0.043in the renal insufficiency patients、p=0.029in the normal renal function patients p=0.014in light chain type and p=0.035in not light chain type). But in stage Ⅰ and Ⅱ there are no difference between T-VAD regimen and T-VD regim (p=0.166). In T-VD group, if the renal function normal or abnormal, or which type and stage the disease is, the efficacy has no difference (p=0.146,0.958and0.462respectively). Adverse reactions of two kinds of regimen were compared by t-test, there are significant differences in peripheral neuropathy and infection. And the side-effects has no difference in patients who are renal insufficiency or not.Conclusion1. The effective rate of T-VD regimen is higher than T-VAD regimen. If the patients complicated with renal sufficiency or not, and if the patients is light chain type or not, and in the ISS Ⅲ stage the efficacy of T-VD regimen always better than the T-VAD regimen. But in the Ⅰ and Ⅱ stage, the efficacy have no obvious difference in the two regimens.2. In the T-VD regimen, the renal function、disease type and stage do not infect the efficacy. In the T-VAD regimen, the renal function and disease stage could infect the efficacy. 3. The rate of side-effects is higher in the T-VD group, but most of them is slight and can be prevented. The rate of side-effects didn’t infect by the renal function.