Efficiency and Tolerability of Induction and Consolidation Therapy with Arsenic Trioxide/Bortezomib/Ascorbic Acid/Dexamethasone (ABCD) Regimen Compared to Bortezomib/Dexamethasone (BD) Regimen in Newly Diagnosed Myeloma Patients
Authors Qian W, Wang L, Li P, Hu Y, Wang Q, Yi K, Wu M, Xu Y, Song J, Chen P, Zhang H, Ma J, Xie Y
Received 16 April 2019
Accepted for publication 5 November 2019
Published 20 January 2020 Volume 2020:12 Pages 431—441
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Kenan Onel
Wensi Qian, 1,* Li Wang, 2,* Pei Li, 3,* Yingwei Hu, 1 Qian Wang, 3 Ke Yi, 1 Min Wu, 1 Yu Xu, 1 Jin Song, 1 Pingping Chen, 1 Hongdi Zhang, 1 Jiexian Ma, 1, 4 Yanhui Xie 1
1Department of Hematology, Huadong Hospital Affiliated with Fudan University, Shanghai, People’s Republic of China; 2Department of Hematology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Qingdao, People’s Republic of China; 3Department of Hematology, Huashan Hospital Affiliated with Fudan University, Shanghai, People’s Republic of China; 4Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated with Fudan University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Yanhui Xie; Jiexian Ma
Department of Hematology, Huadong Hospital Affiliated with Fudan University, Ma 221 West Yan’an Road, Shanghai 200040, People’s Republic of China
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Purpose: This study was aimed at comparing the efficacy and tolerability of an arsenic trioxide/bortezomib/ascorbic acid/dexamethasone (ABCD) regimen with efficacy and tolerability of a bortezomib/dexamethasone (BD) regimen in patients with newly diagnosed myeloma.
Patients and Methods: Fifty-seven and sixty-four patients were treated with the ABCD and BD regimens, respectively. Eligible and agreeable patients received autologous hematopoietic stem cell transplantation followed by consolidation.
Results: The response rates (above VGPR) were 74.1% and 32.8% in the ABCD- and BD-treated groups, respectively (P = 0.000). Compared to BD regimen, ABCD regimen significantly improved PFS (P = 0.026) and OS (P = 0.000) in newly diagnosed patients. Patients with a high tumor burden, low or standard risk, and without auto-HSCT seemed to especially benefit compared to the same group with BD regimen. ABCD also showed better tolerability with lower bone marrow suppression (P = 0.026). Furthermore, complete response or near CR after induction therapy was a good prognostic factor for ABCD-associated OS and PFS.
Conclusion: ABCD is an effective and tolerable regimen compared with BD regimen in newly diagnosed myeloma patients. ABCD regimen could be an economical, effective, and tolerable choice in low- and standard-risk patients.
Keywords: multiple myeloma, arsenic trioxide, bortezomib, overall survival, treatment response
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