title: Therapeutic experience of vincristine/cyclophosphamide/melphalan or mitoxantrone/prednisone combination therapy plus thalidomide as first-line induction therapy for newly diagnosed multiple myeloma in a single institution of China.
abstract: BACKGROUND
  To investigate the safety and efficacy of the combination regimen vincristine, cyclophosphamide, melphalan or mitoxantrone and prednisone (VCMP) plus thalidomide as first-line induction therapy for newly diagnosed multiple myeloma (MM).
  
  
  METHODS
  Three hundred and ninety-six symptomatic, newly diagnosed MM patients were treated with VCMP plus thalidomide in our hospital for the past 11 years, and clinical data of these patients were retrospectively analyzed.
  
  
  RESULTS
  Of the 396 patients enrolled, the total response rate was 77.3%. Forty-three patients relapsed after sCR and CR. Mean cycles to first response were six cycles (range 1-16 cycles). A total of 53% of patients achieved at least a PR within the first cycle of therapy. The actuarial 1-year, 3-year and 5-year overall survival of all patients were 89.4%, 29.5% and 10.6%, respectively. The probabilities of 1-year, 3-year and 5-year progression-free survival of all patients were 84.0%, 23.1% and 8.4%, respectively. The major adverse events were gastrointestinal symptoms, electrolytes and glucose metabolism disorders, hypertension, infection, peripheral nerve disease and hematological adverse events, which were mostly below grade 3 and could be alleviated by symptomatic treatment.
  
  
  CONCLUSIONS
  We concluded that VCMP plus thalidomide is an effective regimen with manageable side effects in the treatment of symptomatic, newly diagnosed MM including elderly patients and patients with renal failure.
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaan Xi, China.
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaan Xi, China.
authors.forename: Pengcheng
authors.initials: P
authors.lastname: He
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaan Xi, China.
authors.forename: Caili
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaan Xi, China.
authors.forename: Chunhong
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaan Xi, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002681:China; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage
chemical_list: D013792:Thalidomide; D003520:Cyclophosphamide; D008942:Mitoxantrone; D008558:Melphalan; D011241:Prednisone
keywords: adverse events; combination regimen; multiple myeloma; progression-free survival