Bortezomib in combination with epirubicin, dexamethasone and thalidomide is a highly effective regimen in the treatment of multiple myeloma: a single-center experience.
The aim of the present study was to evaluate the effectiveness of bortezomib combined with epirubicin, dexamethasone, and thalidomide (BADT) for the treatment of multiple myeloma (MM). The BADT regimen consisted of a maximum of eight 4-week cycles of: intravenous bortezomib (1.0 mg/m(2)) and intravenous epirubicin (12 mg/m(2)) on days 1, 4, 8, and 11; dexamethasone (20 mg) on days 1, 2, 4, 5, 8, 9, 11, and 12; and oral thalidomide (100 mg/m(2)) on days 1-28. Twelve patients with MM were included in the study, of whom four had not been previously treated and eight had been previously treated with at least one cycle of a systemic combined regimen. All the patients completed at least two cycles of treatment, with an average of five cycles; the complete response (CR) rate was 83.3% (10/12) and stabilization of disease was 16.7% (2/12). The average number of cycles required to achieve CR was 1.9 (range 1-6). In three patients, mobilization of peripheral blood stem cells allowed a sufficient quantity of CD34+ cells to be harvested for future autotransplantation. The main adverse reactions included peripheral neuropathy (4/12), thrombocytopenia (3/12), electrocardiographic abnormalities (4/12), neutropenia (5/12), and liver function impairment (4/12), primarily grade I-II. Infection occurred in four patients with neutropenia, including one patient who developed sepsis. The estimated 1-year overall survival rate was 91.7 +/- 8.0%, and the estimated 1-year disease-free survival was 75.0 +/- 12.5%. BADT is a highly effective combined regimen, with acceptable toxicity, for the treatment of multiple myeloma.
Lü
Shuqing
S
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Wang
Jianmin
J
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Xu
Xiaoqian
X
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Ni
Xiong
X
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Huang
Chongmei
C
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Qiu
Huiying
H
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Hu
Xiaoxia
X
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China.
Yang
Jianmin
J
Department of Hematology, Changhai Hospital, Second Military Medical University, 174 Changhai Road, 200433, Shanghai, China. yang3401@yahoo.com.
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D001781:Blood Component Removal; D001897:Boronic Acids / Q000008:administration & dosage* / Q000633:toxicity; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011719:Pyrazines / Q000008:administration & dosage* / Q000633:toxicity; D012074:Remission Induction; D016019:Survival Analysis; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
D001897:Boronic Acids; D011719:Pyrazines; D015251:Epirubicin; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone