• Ahmed Kotb Abdrabou, Al SharifFahadFFrom the Adult Hematology, Stem Cell Transplant and Cellular Therapy, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Riad El Fakih, ZahraniHazaa AlHAFrom the Adult Hematology, Stem Cell Transplant and Cellular Therapy, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Ruah Al Yamany, Mostafa Saleh, Saud Alhayli, Zakia Al Somali, Ahmad Alotaibi, AlFadel AlShaibani, Farah Deeba, Maryam Asif, Syed Ahmed Osman Ali Ahmed, Al FraihFerasFFrom the Adult Hematology, Stem Cell Transplant and Cellular Therapy, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Marwan Shaheen, Ali Alahmari, Walid Rasheed, Naeem Arshad Chaudhri, Al MoharebFahadFFrom the Adult Hematology, Stem Cell Transplant and Cellular Therapy, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Mahmoud Aljurf, and HanbaliAmrAFrom the Adult Hematology, Stem Cell Transplant and Cellular Therapy, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia..
• From the Department of Hematology and Bone Marrow Transplant, Zagazig University, Zagazig, Egypt.
• Ann Saudi Med. 2024 Mar 1; 44 (2): 9310393-103.

BackgroundMultiple myeloma (MM) represents the second most common hematologic malignancy (15%). Induction with bortezomib, cyclophosphamide, and dexamthasone VCd (d: low dose dexamthasone) regimen is widely used due to its high effectiveness, low toxicity and good tolerability, particularly with renal impairment. Real-world data on the use of VCD in clinical practice is lacking.ObjectivesEvaluate the real-world experience of the VCD regimen.DesignRetrospective.SettingTumor registry database of tertiary cancer care center.Patients And Methodsnewly diagnosed MM patients who received VCD induction and underwent autologous stem cell transplant (ASCT) from July 2007 to July 2020.Main Outcome Measuresresponse evaluation, progression-free survival (PFS) and overall survival (OS).Sample Size87 patients.ResultsOf 102 patients who started induction with VCd, 87 patients experienced a partial response or more overall response rate of 85%). The median age of these 87 patients at diagnosis was 52 years, of which 29.9% presented with renal impairment and 60.3% of patients had stage 2 by the Revised International Staging System (R-ISS). Patients with a standard cytogenetic risk achieved a better response compared to those with a poor cytogenetic risk (P=.044). The post-induction response rates were 6.9% stringent complete remission (sCR), 35% complete remission (CR); 41.4% very good partial response (VGPR), and 16.1% partial response (PR), respectively; the response rates became greater for sCR and CR post-transplantation at day 100 with 16.1% sCR, 35.6% CR, 32.2% VGPR and 16.1% PR, respectively. The median PFS was 49 months and 5 years OS was 84%. PFS was better in patients who achieved sCR vs PR (83 vs 35 months, P=.037). High LDH, high-risk cytogenetic and stage 3 R-ISS showed a worse median PFS and OS.ConclusionsVCD induction in newly diagnosed MM is highly effective, convenient, tolerable and affordable regimen, especially in low and middle-income countries with limited resources, also with favorable outcomes and survival. while those who did not respond successfully shifted to VRD or VTD.LimitationsThe usual limitations of a retrospective analysis using registry-level data, no data on quality of life.

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