title: [Efficacy and safety study of subcutaneous injection of bortezomib in the treatment of de novo patients with multiple myeloma].
abstract: OBJECTIVE
  To explore the efficacy and safety of subcutaneous injection of bortezomib in the treatment of de novo multiple myeloma (MM) patients.
  
  
  METHODS
  A total of 36 MM patients treated with bortezomib, adriamycin and dexamethasone (PAD) from January 2012 to April 2013 were analyzed. Among them, 18 received improved PAD (improved PAD group) with the subcutaneous injection of bortezomib, another 18 received conventional PAD (PAD group). The efficacy and safety of two groups were analyzed.
  
  
  RESULTS
  Except 4 cases can not be assessed, 32 patients were evaluated. Of 32 cases, 19(59.4%) achieved complete remission (CR) or very good partial remission (VGPR) after induction therapy, which were 61.1% and 57.1% for PAD group and improved PAD group, respectively (P=1.000). No significant difference between the time to achieve maximum effectiveness in two groups was detected. In the PAD group, one patient (5.6%) died of serious lung infection and eight (44.4%) experienced grade 3 or higher adverse events, while only one (5.6%) discontinued treatment in improved PAD group due to similar toxicity. Compared to PAD group, grade 3 or worse adverse events was significantly reduced in improved PAD group, the most common symptoms were leucopenia (33.3% vs 61.1%, P=0.086), thrombocytopenia (50.0% vs 61.1%), anaemia (27.8% vs 16.7%), infection (16.7% vs 50.0%, P=0.075), diarrhea (5.6% vs 33.3%, P=0.088), peripheral neuropathy(0 vs 27.8%, P=0.045).
  
  
  CONCLUSIONS
  The improved PAD regimen by changing bortezomib from intravenous administration to subcutaneous injection significantly reduced adverse events, improved the safety of clinical application of bortezomib without affecting curative effect, and had great progress.
authors.affiliation: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Lab of Thrombosis & Hemostasis, Ministry of Health, Suzhou 215006, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Cheng-cheng
authors.initials: CC
authors.lastname: Fu
authors.forename: Sheng-li
authors.initials: SL
authors.lastname: Xue
authors.forename: Wei-yang
authors.initials: WY
authors.lastname: Li
authors.forename: Qian
authors.initials: Q
authors.lastname: Wu
authors.forename: Bin
authors.initials: B
authors.lastname: Gu
authors.forename: Song
authors.initials: S
authors.lastname: Jin
authors.forename: Xia-ming
authors.initials: XM
authors.lastname: Zhu
authors.forename: Su-fang
authors.initials: SF
authors.lastname: Zhao
authors.forename: Xue
authors.initials: X
authors.lastname: Xin
authors.forename: Ling
authors.initials: L
authors.lastname: Ma
authors.forename: Ai-ning
authors.initials: AN
authors.lastname: Sun
authors.forename: De-pei
authors.initials: DP
authors.lastname: Wu
mesh_terms: D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D007279:Injections, Subcutaneous; D009101:Multiple Myeloma / Q000188:drug therapy*; D011719:Pyrazines / Q000008:administration & dosage*; D012074:Remission Induction
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin