BACKGROUND:Induction therapy for multiple myeloma (MM) and remission status before high-dose treatment (HDT) have been shown to be prognostic factors for survival outcome, although the optimal induction therapy is yet to be defined.
METHODS:We conducted a retrospective analysis of the impact of induction therapy on survival outcome before and after HDT in MM patients. The study included 236 consecutive patients who underwent HDT.
RESULTS:One hundred and forty-two patients (62%) were treated with vincristine, doxorubicin and dexamethasone (VAD) or cyclophosphamide and betamethasone (CyBet) and 94 (38%) were treated with bortezomib, cyclophosphamide and betamethasone (VCB) as induction. Time to first and time to best response was faster in the VCB group than in the VAD/CyBet group, with 42 versus 75 (p < 0.001) and 54 versus 88 days (p < 0.001), respectively. After induction therapy, 49% of the patients in the VCB group and 38% in the VAD/CyBet group achieved a very good partial response or better. Multivariate analysis revealed younger age, lower International Staging System stage and induction treatment with VCB as variables associated with favourable time to progression.
CONCLUSIONS:Outcome measured as response and time to progression before and after HDT in MM differs depending on type of induction treatment and suggests that VCB is a highly effective induction regimen that confers a post-HDT advantage.
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【A combination regimen of bortezomib, cyclophosphamide and betamethasone gives quicker, better and more durable response than VAD/CyBet regimens: results from a Swedish retrospective analysis.].
【硼替佐米，环磷酰胺和倍他米松的联合治疗方案比VAD / CyBet治疗方案具有更快，更好和更持久的应答：瑞典一项回顾性分析的结果。】
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DOI：10.1159/000345422文章类型：杂志文章
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摘要背景：对多发性骨髓瘤（MM）的诱导治疗和大剂量治疗（HDT）之前的缓解状态已被证明是生存结果的预后因素，尽管最佳诱导治疗尚待确定。
方法：我们对诱导疗法对MM患者HDT前后生存结果的影响进行了回顾性分析。该研究包括236名接受HDT治疗的连续患者。
结果：142例患者（62％）接受了长春新碱，阿霉素和地塞米松（VAD）或环磷酰胺和倍他米松（CyBet）的治疗，而94例（38％）接受了硼替佐米，环磷酰胺和倍他米松（VCB）的治疗。 VCB组的首次响应时间和最佳响应时间比VAD / CyBet组更快，分别为42天与75天（p <0.001）和54天与88天（p <0.001）。诱导治疗后，VCB组中49％的患者和VAD / CyBet组中38％的患者获得了很好的局部缓解或更好的缓解。多变量分析显示年龄较小，国际分期系统阶段较低和以VCB作为与进展良好时间相关的变量进行诱导治疗。
结论：根据诱导治疗的类型不同，MM发生HDT前后反应和进展时间的结果也有所不同，这表明VCB是一种高度有效的诱导方案，具有HDT后的优势。
方法：我们对诱导疗法对MM患者HDT前后生存结果的影响进行了回顾性分析。该研究包括236名接受HDT治疗的连续患者。
结果：142例患者（62％）接受了长春新碱，阿霉素和地塞米松（VAD）或环磷酰胺和倍他米松（CyBet）的治疗，而94例（38％）接受了硼替佐米，环磷酰胺和倍他米松（VCB）的治疗。 VCB组的首次响应时间和最佳响应时间比VAD / CyBet组更快，分别为42天与75天（p <0.001）和54天与88天（p <0.001）。诱导治疗后，VCB组中49％的患者和VAD / CyBet组中38％的患者获得了很好的局部缓解或更好的缓解。多变量分析显示年龄较小，国际分期系统阶段较低和以VCB作为与进展良好时间相关的变量进行诱导治疗。
结论：根据诱导治疗的类型不同，MM发生HDT前后反应和进展时间的结果也有所不同，这表明VCB是一种高度有效的诱导方案，具有HDT后的优势。
