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Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma

BACKGROUND: Outcome in multiple myeloma (MM) has improved substantially over recent years as a result of the availability of multiple novel agents with acceptable safety profile. STUDY DESIGN: Prospective observational study at a tertiary care institute. METHODS: Twenty-five newly diagnosed patients...

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Autores principales: Hassan Zafar, Mir Sadaqat, Khan, Afaq Ahmed, Aggarwal, Shyam, Bhargava, Manorama
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865101/
https://www.ncbi.nlm.nih.gov/pubmed/29600238
http://dx.doi.org/10.4103/sajc.sajc_59_17
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author Hassan Zafar, Mir Sadaqat
Khan, Afaq Ahmed
Aggarwal, Shyam
Bhargava, Manorama
author_facet Hassan Zafar, Mir Sadaqat
Khan, Afaq Ahmed
Aggarwal, Shyam
Bhargava, Manorama
author_sort Hassan Zafar, Mir Sadaqat
collection PubMed
description BACKGROUND: Outcome in multiple myeloma (MM) has improved substantially over recent years as a result of the availability of multiple novel agents with acceptable safety profile. STUDY DESIGN: Prospective observational study at a tertiary care institute. METHODS: Twenty-five newly diagnosed patients of MM were treated with bortezomib and dexamethasone induction with monitoring for response and safety, followed by peripheral blood autologous stem cell transplant (PBASCT) in eligible patients or maintenance. RESULTS: Out of 25 patients, 32% attained complete response (CR), 56% very good partial response (VGPR), 4% PR, and 8% showed no response. The overall response rate was 92%. In our study, 56% of patients showed hematological side effects, out of which thrombocytopenia was seen in 32%, anemia in 16%, and leukopenia in 8%. Six patients developed bortezomib-induced peripheral neuropathy, out of which four had grade 1 (66.66%), one had grade 2 (16.66%), and 1 (16.66%) had grade 3 toxicity. Sixteen patients were eligible for PBASCT, out of which eight patients received this therapy while as remaining eight patients opted for two more cycles of induction therapy followed by maintenance. After completing 18 months of maintenance, all the eight patients who underwent PBASCT were in CR. Out of the 15 patients who did not receive PBASCT five attained CR, eight VGPR while as two patients relapsed. CONCLUSION: Bortezomib plus dexamethasone is highly effective and well-tolerated regimen for frontline treatment of MM with a higher quality of response in an advanced stage and renal failure patients.
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spelling pubmed-58651012018-03-29 Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma Hassan Zafar, Mir Sadaqat Khan, Afaq Ahmed Aggarwal, Shyam Bhargava, Manorama South Asian J Cancer ORIGINAL ARTICLE: Leukemia, Lymphoma & Plasma Cell Disorder BACKGROUND: Outcome in multiple myeloma (MM) has improved substantially over recent years as a result of the availability of multiple novel agents with acceptable safety profile. STUDY DESIGN: Prospective observational study at a tertiary care institute. METHODS: Twenty-five newly diagnosed patients of MM were treated with bortezomib and dexamethasone induction with monitoring for response and safety, followed by peripheral blood autologous stem cell transplant (PBASCT) in eligible patients or maintenance. RESULTS: Out of 25 patients, 32% attained complete response (CR), 56% very good partial response (VGPR), 4% PR, and 8% showed no response. The overall response rate was 92%. In our study, 56% of patients showed hematological side effects, out of which thrombocytopenia was seen in 32%, anemia in 16%, and leukopenia in 8%. Six patients developed bortezomib-induced peripheral neuropathy, out of which four had grade 1 (66.66%), one had grade 2 (16.66%), and 1 (16.66%) had grade 3 toxicity. Sixteen patients were eligible for PBASCT, out of which eight patients received this therapy while as remaining eight patients opted for two more cycles of induction therapy followed by maintenance. After completing 18 months of maintenance, all the eight patients who underwent PBASCT were in CR. Out of the 15 patients who did not receive PBASCT five attained CR, eight VGPR while as two patients relapsed. CONCLUSION: Bortezomib plus dexamethasone is highly effective and well-tolerated regimen for frontline treatment of MM with a higher quality of response in an advanced stage and renal failure patients. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5865101/ /pubmed/29600238 http://dx.doi.org/10.4103/sajc.sajc_59_17 Text en Copyright: © 2018 The South Asian Journal of Cancer http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle ORIGINAL ARTICLE: Leukemia, Lymphoma & Plasma Cell Disorder
Hassan Zafar, Mir Sadaqat
Khan, Afaq Ahmed
Aggarwal, Shyam
Bhargava, Manorama
Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
title Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
title_full Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
title_fullStr Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
title_full_unstemmed Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
title_short Efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
title_sort efficacy and tolerability of bortezomib and dexamethasone in newly diagnosed multiple myeloma
topic ORIGINAL ARTICLE: Leukemia, Lymphoma & Plasma Cell Disorder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865101/
https://www.ncbi.nlm.nih.gov/pubmed/29600238
http://dx.doi.org/10.4103/sajc.sajc_59_17
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