The Study Of Yishenhuoxueyin And Low-dose Bortezomib Based Regimens In The Treatment Of Newly Diagnosised Multiple Myeloma In Elderly Patients

ObjectiveTo evaluate the short-term efficacy,long-term survival and adverse reactions of Yishenhuoxueyin and low-dose bortezomib-based regimens in the treatment of newly diagnosised Multiple Myeloma in elderly patients,and provide evidence to confirm the regimen' s benefit.MethodsWe retrospected analysis of clinical data of 58 newly diagnosed multiple myeloma elderly patients who received Yishenhuoxueyin-and low-dose bortezomib-based regimens for more than 2 cycles from January 2014 to December 2018,evaluated the short-term efficacy of this regimens according to the efficacy standard established by EBMT in 2006.The safety and adverse events of this regimens were evaluated by referring to the National Cancer Institute General CTCAE 4.0 standard.Meanwhile the effect of Yishenhuoxueyin on improving efficacy and reducing toxicity of this regimen was evaluated.The survival was analyzed by follow-up until February 2019.Results1.of the 58 newly diagnosised elderly patients with MM,33(56.9%)were male and 25(43.1%)were female,with a median age of 70(65?85)years.In this study,the median treatment cycle was 4,and the maximum treatment cycle was 8,of which 39 patients received 4 cycles or more.The average dose of bortezomib was 1.11±0.11 mg/m2,the median dose was 1.11 mg/m2(range,0.80?1.29 mg/m2).2.Response rate:overall response rate was 84.5%,with 32.8%of patients achieving a complete response,48.3%of patients achieving a Partial response,3.4%of patients achieving a Minimal response,8.6%of patients No change,6.9%of patients Disease progression and 81.0%of patients achieving a partial response or better3.Adverse events:The main adverse events includ Hematological toxicity,digestive system,neuropathy,infection etc.There was hematological toxicity in 18(31.0%)patients,electrolytes disorder in 22(37.9%)patients,digestive in 23,peripheral neuropathy in 9(19%)patients,infection in 14(24.1%)patients,and Other toxicity were deep venous thrombosis in 2 patients,heart failure in 1 patient,atrial fibrillation in 2 patients and drug-induced rash in 2 patients.All adverse events could be improved after treatment.4.survival:4 patients(6.9%)died and 3 patients(5.2%)were lost to follow-up.With a median follow-up of 17 months,the median PFS was 16 months(range,0?50 months),and OS was 17 months(range,2?59 months).Patients with deep response had better PFS and OS than those had no response.Conclusion1.Yishenhuoxueyin and low-dose bortezomib based regimens for newly diagnosised multiple myeloma in elderly patients can get satisfied short-term effect,especially those receiving higher doses and full-course treatment achieved deeper responses.2.Yishenhuoxueyin-and low-dose bortezomib based regimens can reduce adverse events rate in the treatment of newly diagnosised Multiple Myeloma in elderly patients.3.Yishenhuoxueyin and low-dose bortezomib-based regimens can prolong survival in elderly patients with newly diagnosed multiple myeloma,and patients with better remission after treatment can get better PFS and OS.