Cancer Management and Research (Jan 2020)

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

  • 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

Journal volume & issue
Vol. Volume 12
pp. 431 – 441

Abstract

Read online

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 workCorrespondence: Yanhui Xie; Jiexian MaDepartment of Hematology, Huadong Hospital Affiliated with Fudan University, Ma 221 West Yan’an Road, Shanghai 200040, People’s Republic of ChinaTel +86-21-62483180 Ext.80216; +86-21-62483180 Ext.81303Fax +86-21-62495490Email [email protected] [email protected]: 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

Keywords