Abstract:

Objective To evaluate the curative effect of Bortezomib based chemotherapy in treatment of patients with newly diagnosed multiple myeloma, and explore the prognositic factors. Methods Thirty-eight patients with newly diagnosed multiple myeloma received Bortezomib based chemotherapy, and the drugs used in chemotherapy included Melphalan+Prednisone, Dexamethasone, Dexmethasone+Cyclophosphamide or Dexamethasone+Adriamycin. Each course of treatment lasted for 3 to 4 weeks, and intravenous injection of 1.3 mg/m² Bortezomib was performed on the 1st, 4th, 8th and 11th day of each course. Patients were managed with 2 to 10 courses. Response to Bortezommib was assessed according to the criteria of European Group for Blood and Marrow Transplantation, and adverse events were evaluated according to the criteria of National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0. The prognosis factors were analysed by Log-rank test and COX regression model. Results The median duration of follow-up was 19 months. The overall response rate (complete remission+very good partial remission+partial remission) was 86.84%. The median progression-free survival was 19.47 months, and the median overall survival was 39.17 months. Univariate analysis and multivariate analysis revealed that complete remission and very good partial remission after treatment were prognostic factors, while M protein typing, age, Durie-salmon staging, high serum creatinine, low hemoglobin, low albumin, high β2 microglobulin and high lactate dehydrogenase were not related to prognosis. The major adverse events during treatment were gastrointestinal sympotoms, leukocytopenia, thrombocytopenia, peripheral neuropathy and fatigue. Conclusion Bortezomib based chemotherapy is well tolerated and effective in treatment of patients with newly diagnosed multiple myeloma, which overcomes the poor prognosis conferred by traditional prognosis factors.

Key words: multiple myeloma, Bortezomib, curative effect, prognosis