CTD与PCD方案治疗新诊断多发性骨髓瘤患者的疗效、预后及安全性分析

OBJECTIVE: To observe the efficacy and safety of CTD (cyclophosphamide, thalidomide, dexamethasone) and PCD (bortezomib, cyclophosphamide, dexamethasone) regimens in treatment of patients with newly diagnosed multiple myeloma (NDMM). METHODS: A retrospective analysis was carried out on 88 cases of NDMM patients admitted to our hospital from July 2013 to January 2016, including 49 cases in CTD group and 39 cases in PCD group. The outcomes of two different regimens were analyzed, including response, prognosis, and adverse events. RESULTS: The total overall remission rates (ORR, better than PR) of CTD and PCD were 65.3% (32/49) and 84.6% (33/39), while very good partial response (VGPR) were 30.6% (15/49) and 53.8% (21/39), and differences were statistically significant (P=0.041, P=0.028). The median follow-up was 11.5 (3–33) months. The median progression-free survival (PFS) was (23.0±4.5) months in CTD groups, but it was not achieved in PCD group, with statistically significant differences (P=0.050). Medial overall survival was not achieved in both two groups, without statistically significant difference (P=0.257). There were statistical differences between patients with minor response (MR) and patients without MR in medium OS in CTD group (P=0.005), and there were statistical difference between patients with VGPR and without VGPR in medium OS in CTD group (P=0.042). Infection was a common adverse event in two groups. The incidences of peripheral neuropathy and herpes zoster were markedly higher in PCD group than CTD group, and the incidences of thrombus, palpation and rash, etc., were higher in CTD group. CONCLUSION: Both CTD and PCD regimens were effective first-line induction chemotherapy choice for NDMM. PCD regimen is better than CTD in treatment power and deep remission.