• Zhonghua nei ke za zhi · Nov 2014

    [Bortezomib-based induction therapy followed by autologous hematopoietic stem cell transplantation in multiple myeloma].

    • Beihui Huang, Juan Li, Junru Liu, Jingli Gu, Dong Zheng, Duorong Xu, Waiyi Zou, and Hehua Wang.
    • Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
    • Zhonghua Nei Ke Za Zhi. 2014 Nov 1; 53 (11): 865-72.

    ObjectiveTo evaluate the short-term and long-term effect of novel agents followed by autologous hematopoietic stem cell (ASCT) in Chinese multiple myeloma(MM) patients in order to find out the optimal therapeutic regimen for transplant-eligible patients.MethodsClinical data of 100 active MM patients receiving bortezomib-based induction regimens followed by high-dose melphalan and ASCT were retrospectively analyzed from June 1, 2006 to January 30, 2014.ResultsThe overall response rates(ORR) after induction therapy, transplantation and consolidation and maintenance therapy were respectively 90.0%, 97.0%, and 98.9%. The median progress free survival(PFS) was 42.3 months. The median overall survival(OS) was not reached. The cumulative near complete response (nCR)+complete respanse(CR) rate was no longer improved after 4 cycles of induction therapy for non-light chain type MM and two cycles for light-chain type. In newly-diagnosed light-chain type MM patients, the cumulative nCR+CR rate after 4 cycles of bortezomib plus dexamethasone (VD) regimen was similar to that of bortezomib, doxorubicin and dexamethasone (PAD). While for those non-light-chain types, three drug-based regimen was better than two drug-based. PFS of patients receiving early ASCT was longer than that of late ASCT (50.7 months vs 26.6 months, P = 0.023) . PFS in patients receiving autologous bone marrow stem cell transplantation (ABMSCT) was longer than that of autologous peripheral blood stem cell transplantation (APBSCT) (NA vs 36.1 months, P = 0.049) . Maintenance therapy was beneficial regardless of the response rate after ASCT. Patients with CR at any time during the therapy had longer PFS than those with nCR.ConclusionsBortezomib-based therapy followed by ASCT is the first line therapy for transplant-eligible MM patients. Patients with different types of M protein require different induction regimens. Maintenance is beneficial to patients after ASCT, no matter whether a CR is reached or not. Patients with CR after induction or ASCT tend to have longer survival.

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