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A Combination Regimen of Bortezomib, Cyclophosphamide and Betamethasone Gives Quicker, Better and More Durable Response than VAD/CyBet Regimens: Results from a Swedish Retrospective Analysis
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2013 (English)In: Acta Haematologica, ISSN 0001-5792, E-ISSN 1421-9662, Vol. 130, no 1, 7-15 p.Article in journal (Refereed) Published
Abstract [en]

Background: Induction therapy for multiple myeloma (MM) and remission status before high-dose treatment (HDT) have been shown to be prognostic factors for survival outcome, although the optimal induction therapy is yet to be defined. Methods: We conducted a retrospective analysis of the impact of induction therapy on survival outcome before and after HDT in MM patients. The study included 236 consecutive patients who underwent HDT. Results: One hundred and forty-two patients (62%) were treated with vincristine, doxorubicin and dexamethasone (VAD) or cyclophosphamide and betamethasone (CyBet) and 94 (38%) were treated with bortezomib, cyclophosphamide and betamethasone (VCB) as induction. Time to first and time to best response was faster in the VCB group than in the VAD/CyBet group, with 42 versus 75 (p < 0.001) and 54 versus 88 days (p < 0.001), respectively. After induction therapy, 49% of the patients in the VCB group and 38% in the VAD/CyBet group achieved a very good partial response or better. Multivariate analysis revealed younger age, lower International Staging System stage and induction treatment with VCB as variables associated with favourable time to progression. Conclusions:Outcome measured as response and time to progression before and after HDT in MM differs depending on type of induction treatment and suggests that VCB is a highly effective induction regimen that confers a post-HDT advantage. 

Place, publisher, year, edition, pages
2013. Vol. 130, no 1, 7-15 p.
Keyword [en]
High-dose therapy, Multiple myeloma, Vincristine, doxorubicin and dexamethasone regimen
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-205404DOI: 10.1159/000345422ISI: 000321465800002OAI: oai:DiVA.org:uu-205404DiVA: diva2:642143

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Available from: 2013-08-20 Created: 2013-08-16 Last updated: 2014-10-10Bibliographically approved

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