title: [Bortezomib-based induction therapy followed by autologous hematopoietic stem cell transplantation in multiple myeloma].
abstract: OBJECTIVE
  To 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.
  
  
  METHODS
  Clinical 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Bortezomib-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.
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Beihui
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. Email: 13719209240@163.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Junru
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Jingli
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zheng
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Duorong
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Waiyi
authors.initials: W
authors.lastname: Zou
authors.affiliation: Department of Hematology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Hehua
authors.initials: H
authors.lastname: Wang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D003907:Dexamethasone / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000009:adverse effects; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy*; D009194:Myeloma Proteins; D036102:Peripheral Blood Stem Cell Transplantation; D011719:Pyrazines / Q000008:administration & dosage*; D012074:Remission Induction; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D009194:Myeloma Proteins; D011719:Pyrazines; C085016:multiple myeloma M-proteins; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin