VAD Chemotherapy Versus Bortezomib Containing Regimens As Remission Induction For ASCT in Multiple Myeloma: A Single Center Experience

  • Aysun Senturk Yikilmaz Mail Department of Hematology, Yıldırım Beyazıt University, Ankara 06010, Turkey
  • Sema Akinci Department of Hematology, Ataturk Training And Research Hospital, Ankara 06010, Turkey
  • Sule Mine Bakanay Department of Hematology, Yıldırım Beyazıt University, Ankara 06010, Turkey
  • İmdat Dilek Department of Hematology, Yıldırım Beyazıt University, Ankara 06010, Turkey
Keywords:
Multiple myeloma, VAD, Autologous stem cell transplantation, Bortezomib

Abstract

Background: Complete response (CR) and very good partial response (VGPR) are targeted with pre-ASCT induction regimens in patients by diagnosed multiple myeloma (MM), who are candidates for ASCT. In this study, it was aimed to compare the response and survival evaluations of cases who underwent induction treatment by vincristine-doxorubicin-dexamethasone (VAD) protocol versus bortezomib containing regimens.

Materials and Methods: The data of 96 ASCT eligible patients, retrospectively analyzed. P value> 0.05 was considered statistically significant.

Results: While 66 cases had received bortezomib containing regimens as induction regimen, 30 cases had received VAD protocol. The total survival was 91.3 (st.s 6) months and 43 (st.s 7.9) months, respectively, when we compared the cases without ASCT and with ASCT (p = 0.001). The OS of patients who underwent ASCT after reaching at least VGPR was longer than the underwent ASCT without reaching VGPR (p=0.019).  Post-ASCT PFS (p=0.717) and OS (p = 0.126) analyzes were performed in 74 cases undergoing ASCT treatment, there was no significant statistical difference when patients with treated by VAD protochol and treated by bortezomib containing regimens as pre-ASCT induction regimens was compared to each other.

Conclusion: Whatever the type of induction regimen is, the level of response achieved before ASCT is important. The survival of the myeloma patients are much more influenced with HDT-ASCT as well as post-transplantation strategies to keep the patients in remission. Even though it is outdated, we think that the VAD protocol may be an option in patients who are not responding with the new generation of agents in the following days.

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Published
2020-10-07
How to Cite
1.
Senturk Yikilmaz A, Akinci S, Bakanay S, Dilek İmdat. VAD Chemotherapy Versus Bortezomib Containing Regimens As Remission Induction For ASCT in Multiple Myeloma: A Single Center Experience. Int J Hematol Oncol Stem Cell Res. 14(4):257-265.
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Original Article(s)