Real life data comparing weekly VCD and twice weekly VCD protocols in newly diagnosed multiple myeloma patients

Abstract

Background This study aimed to evaluate the efficacy and side effects of bortezomib, cyclophosphamide, and dexamethasone (VCD) treatment, which is frequently preferred in primary care in patients with multiple myeloma in our country, with two applications per week and one application per week. Methods A total of 141 patients who received VCD in the induction treatment of newly diagnosed multiple myeloma were retrospectively reviewed and analyzed. Both treatment groups were evaluated in terms of efficacy and side effects. Results A total of 141 patients with newly diagnosed multiple myeloma who received VCD in induction therapy were included in the study. The median age was 62 years. Among the 141 patients included in the study, 57 received treatment two days a week, and 84 received treatment one day a week. Sixty-one (43.3%) patients were female and 80 (56.7%) were male. There was no significant difference between the two groups regarding post-treatment response rates after the 2nd cycle VCD regimen (p=0.378) and the 4th cycle VCD regimen (p=0.965). Patients receiving weekly VCD regimens had a significantly higher rate of receiving other regimens, and the additional VCD regimen of autologous stem cell transplant (ASCT) was significantly higher in patients who received a VCD regimen twice a week compared to the other group (p<0.001). ASCT was performed in 73% of the patients (n: 103). In 54 patients with ASCT at the end of the 4th cycle VCD, there was no significant difference between very good partial response/complete response rates and partial response/sub responses between the two groups according to the 3rd month post-transplant responses (p=0.612). Neuropathy was observed in seven (12.3%) patients receiving twice-weekly VCD regimens, while neuropathy was observed in 16 (19.3%) and neutropenia in two (2.4%) patients receiving weekly VCD regimens. The two groups had no significant difference regarding side effects (p=0.387). Conclusion Our study found no significant difference in the treatment response rates of patients receiving weekly VCD and twice-weekly VCD. The low rates of ASCT in the weekly VCD group were thought to be related to the fact that the patients receiving the weekly regimen were older than the other group and were unsuitable for ASCT due to age. No difference was observed between the two groups regarding the frequency of side effects.

Keywords

• Myeloma
• induction
• bortezomib
• cyclophosphamide
• dexamethasone

References

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