The Curative Effect Of Different Concentration Of Bortezomib In MM First Treated Patients Those Are Suitable For Transplantation And Retrospective Analysis Of 124 Patients With Transplant Surial

Objective: To evaluate the impact on different concentration of bortezomib in multiple myeloma patients who should received autologous stem cell transplantation after inductions with bortezomib and thalidomide and dexamethasone by curative effect and safety.Methods: Selected 40 patients newly diagnosed multiple myeloma from 2011 June to 2014 June period in our hospital. All the patients were divided into two group by random after inductions with bortezomib and thalidomide and dexamethasone, with different concentration of bortezomib 1.0mg/m2 and 1.3mg/m2. After receiving the inductions treatment curative effect and safety were observed and compared, and the by statistical analysis by the second and forth course of treatment. Those who got very good partial response would receive autologous stem cell transplantation through their own accord, while the there would receive maintenance treatment with bortezomib and thalidomide and dexamethasone. Patients were evaluated every 2 to 3 months and survivals were compared by the end of the follow-up.Results: There was no significant difference in the general curative effect, the total response rate(ORR) and complete response rate(CRR) by the second and forth course of treatment of inducions.In terms of adverse reaction of chemotherapy, incidence of adverse reactions were lower than the standard dose group in digestive tract reaction, peripheral neuropathy, blood system toxicity, and infection without significant correlation. All the median progression-free survival was prolonged and median overall survival was extended(P<0.05) in patients with autologous stem cell transplantation. Progression-free survival(p=0.003) and overall survival(p=0.037) were both significantly prolonged in the high-risk subgroup after autologous stem cell transplantation; while in the intermediate-risk and low-risk subgroups, neither progression-free survival nor overall survival was prolonged significantly after autologous stem cell transplantation(p>0.05).Conclusion: There was no significant difference in the different concentration groups of borezomib after indctions, as well as the physical condition that these patients are suitable for transplantation of patients with initial therapy and related factors. High-risk myeloma patients, based on cytogenetic and ISS stratifications, can benefit most from autologous stem cell transplantation consolidation even in the era of novel agents.