International Journal of Hematology

DOI: 10.1007/s12185-019-02764-1 Pages: 103-111

Bortezomib, lenalidomide, and dexamethasone in transplant-eligible newly diagnosed multiple myeloma patients: a multicenter retrospective comparative analysis

1. The Jikei University Kashiwa Hospital, Division of Clinical Oncology/Hematology, Department of Internal Medicine

2. The Jikei University School of Medicine, Division of Clinical Oncology/Hematology, Department of Internal Medicine

3. Japanese Red Cross Medical Center, Department of Hematology

4. The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Department of Hematology Oncology

5. Hamamatsu University School of Medicine, Division of Hematology, Internal Medicine 3

Correspondence to:
Kazuhito Suzuki
Email: kaz-suzuki@jikei.ac.jp

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Abstract

The combination of bortezomib, lenalidomide, and dexamethasone (VRD) is used as induction treatment in multiple myeloma; however, the optimum schedule for this regimen remains controversial. In this retrospective study, we compared the efficacy and tolerability of twice-weekly VRD (twVRD) and modified VRD-lite in transplant-eligible myeloma patients. Fifty-five patients (median age 61 years) were included; 22 received twVRD (bortezomib [1.3 mg/m2 on days 1, 4, 8, and 11] and lenalidomide [25 mg/body on days 1–14] over 21-day cycles) and 33 received modified VRD-lite (bortezomib [1.3 mg/m2 on days 1, 8, 15, and 22) and lenalidomide [15 mg/body on days 2–7, 9–14, 16–21] over 28-day cycles). Overall response, very good partial response, and complete response rates after VRD were 96.4%, 45.5%, and 20.0%, respectively (median follow-up period, 17.7 months). The 1-year progression-free survival (PFS) and overall survival rates were 95.8% and 98.2%, respectively. The response rate and PFS were similar between the groups, regardless of cytogenetic risk and age. The incidence of peripheral neuropathy ≥ grade 2 and thrombocytopenia ≥ grade 3 was higher in the twVRD group (27.2% vs. 0.0%, P = 0.003 and 27.2% vs. 0.0%, P = 0.003). In conclusion, modified VRD-lite had similar efficacy with, but better tolerability than, twVRD in transplant-eligible patients.

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