నైరూప్య

Effect of different therapeutic regimens on the elderly patients with multiple myeloma

Chen Ge, Peng Cao, Xiang-yang Xu

Objective: To explore the effect of different therapeutic regimens on the patients with Multiple Myeloma (MM).

Methods: In Melphalan and Prednisone (MP) group, patients received 8 mg/m²/d melphalan and 60 mg/m²/d prednisone for 6 cycles (7 days each cycle). In M2 (VMBCP) group, patients received 1 mg/m²/d vincristine, 20 mg/m²/d carmustine and 400 mg/m²/d cyclophosphamide on Day 1, 8 mg/m²/d melphalanon Day 1-4, and 30 mg/m²/d prednisone on Day 1-14 for 6 cycles (14 days each cycle). In M2 and MP group, two regimens were applied alternately for 6 cycles. In Multiple CCT groups, multiple combination chemotherapy were adopted, including VMCP regimen (0.4 mg/m²/d vincristine and 100 mg/m²/d cyclophosphamide on Day 1, 8 mg/m²/d melphalan on Day 1-4 and 60 mg/m²/d prednisone Day 1-14), VBAP regimen (1 mg/m²/d vincristine and 75-100 mg/m²/d carmustine on Day 1, 30 mg/m²/d doxorubicin and 60 mg/m²/d prednisone on Day 1-4), VAD regimen (0.4 mg/m²/d vincristine on Day 1-4 with infusion for 24 h, 40 mg/m²/d dexamethasone on Day 1-4, 9-12 and 1720), CVP regimen (100 mg/m²/d cyclophosphamide and 0.4 mg/m²/d vincristine on Day 1-4, 60 mg/m²/d prednisone on Day 1-14) and ECP regimen (100 mg/m²/d etoposide on Day 3-5, 100 mg/m²/d cyclophosphamide and 60 mg/m²/d prednisone on Day 1-5). Response rate and survival time of different groups are compared.

Results: The total response rate of 100 patients treated with conventional chemotherapy was 46.0%, and complete response rate and partial response rate were 15.0% and 31.0%, respectively. The total response rate of patients treated with combination chemotherapy was significantly higher than that of patients treated with melphalan and prednisone (59.1% vs. 29.2%, t=38.456, P<0.05). The median survival time, 3 and 5 year overall survival of 108 MM patients were 31.0 months, 33.0% and 16.1%, respectively.

Conclusions: Combination chemotherapy could be used for the patients with multiple myeloma.