A combination of lenalidomide, bortezomib, and dexamethasone (RVD) provides deep-er responses in patients with newly diagnosed multiple myeloma
10.3969/j.issn.1000-8179.2019.14.994
- VernacularTitle:RVD方案对新诊断多发性骨髓瘤患者缓解深度的研究*
- Author:
Jing JIA
1
;
Aijun LIU
;
Wenming CHEN
;
Yin WU
;
Yanchen LI
;
Yun LENG
;
Wen GAO
Author Information
1. 首都医科大学附属北京朝阳医院血液科(北京市100020)
- Keywords:
multiple myeloma (MM);
lenalidomide;
bortezomib;
minimal residual disease (MRD)
- From:
Chinese Journal of Clinical Oncology
2019;46(14):734-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective: This study investigated the efficacy and safety of a combination of lenalidomide, bortezomib, and dexametha-sone (RVD) in patients with newly diagnosed multiple myeloma (NDMM). Methods: The clinical features and responses of 48 patients with NDMM who were treated with RVD from January 2015 to May 2019 in Beijing Chaoyang Hospital were retrospectively analyzed. Results: The median age of the 48 patients was 59 years (range: 34-79). Among these, 44 patients were Durie-Salmon stageⅢ, 15 were ISS stageⅡ, 19 were ISS stageⅢ, and 12 had plasmacytoma; 32.5% of all patients were cytogenetic high-risk. All patients re-ceived a median of four cycles (range: 1-9) of the RVD regimen as induction treatment. The overall response rate was 97.9%, with 35.4% of patients achieving complete response (CR) or better. The rate of very good partial remission (VGPR) or better was increased from 64.1% (after two cycles) to 84.6% (after four cycles). The mean collection of CD34+cells was 4.2 (± 2.6)×106/kg. Negative minimal residual disease (MRD), as indicated by next-generation flow (NGF), was achieved in 20.6% of patients after induction. Two patients with positive MRD after induction became MRD negative after transplantation. Two patients developed grade 3 or 4 hematologic toxic-ity. No nonhematologic toxicity of grade 3 or 4 was observed. Conclusions: In patients with NDMM, RVD treatment resulted in signifi-cantly improved response rates and exhibited an acceptable risk-benefit profile, with no adverse impact on stem cell collection. RVD combined with transplantation significantly improved the negative rate of MRD, as indicated by NGF.
