Clinical Efficacy Of Bortezomib Combined With Dexamethasone And Thalidomide Regimen For Multiple Myeloma

ObjectiveTo explore the clinical efficacy and safety of Bortezomib in combination with Dexamethasone and Thalidomide in the treatment of multiple myeloma(MM). MethodCollecting 112 diagnosed MM patients in the first affiliated hospital of ZhengZhou university during November,2010 to November,2014,including 60 male and 52 female, age arrange from 39 to 81 years old(the median age was 59 years old),Fifty-eight newly diagnosed patients and Fifty-four relapsed or refractory MM patients. They were treated with BDT regimen:bortezomib(0.9~1.3 mg/m2) by rapid intravenous injection or subcutaneous injection on the 1th,4th,8th and 11 th day;dexamethasone(10~20 mg/d) by intravenous drip(dayl~2, day4~5, day8~9, day11~12,or day1~4, day8~11);Oral thalidomide(50~200mg/d) was given for the whole course,every three weeks as one cycle of treatment. Diagnosis was in conformity with the criteria of? Chinese Guideline for the Diagnosis and Treatment of Multiple Myeloma(2015 Revised Edition)?, the curative effect was assessed according to myeloma international unification curative effect standard set by the International Myeloma Working Group in 2006(IMWG). Adverse reaction was valued according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version4.0. Data processing was completed by the software SPSS 19.0, the compare of qualitative variable was analyzed byc2 test. A level of significance of P<0.05 was used. ResultsThe total CR rate, VGPR rate and PR rate was 12.5%,12.5%,48.2%respectively,and CR+VGPR rate,the overall response rate was 25.0%,73.2% separately?The ORR rate,CR rate, VGPR rate,PR rate and CR+VGPR rate in newly diagnosed group and relapsed or refractory MM group was 82.8%,17.2%,17.2%,48.3%,34.5% respectively and 63.0%,7.4%,7.4%,48.1%,14.8%and there was no statistic significance in the compare of the two groups(P>0.05).The overall response rate of patients with bortezomib(1.1~1.3 mg/m2) is higher, and had statistical significant difference(P=0.034)with bortezomib(0.9~1.0 mg/m2). But there was no significant difference between the effects of bortezomib by subcutaneous injection and rapid intravenous injection. Different degrees of reactions were found in one hundred(89.2%)MM patients with BDT regimen, including fatigue(70.5%)?peripheral neuropathy(66.1%)?thrombocytopenia(35.7%)?infection(30.3%)?neutropenia(26.8%)?nausea and vomiting(17.9%)?There was statistical significance(P=0.013)between peripheral neuropathy rate in intravenous injection group(73.1%)and subcutaneous injection group(45.3%). ConclusionThe efficacy of Bortezomib in combination with Dexamethasone and Thalidomide for the treatment of Multiple Myeloma is curative. The main adverse reactions were fatigue ? thrombocytopenia ? infection ? neutropenia ? peripheral neuropathy ?nausea and vomiting. Most of the adverse effects were mild and could be relieved by symptomatic treatments and withdrawal. This regimen reserve popularization and application.