• Media type: E-Article
  • Title: 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
  • Contributor: Uttervall, Katarina; Admasie, Johannes; Alici, Evren; Lund, Johan; Liwing, Johan; Aschan, Johan; Barendse, Mirjam; Deneberg, Stefan; Mellqvist, Ulf-Henrik; Carlson, Kristina; Nahi, Hareth
  • imprint: S. Karger AG, 2013
  • Published in: Acta Haematologica
  • Language: English
  • DOI: 10.1159/000345422
  • ISSN: 0001-5792; 1421-9662
  • Keywords: Hematology ; General Medicine
  • Origination:
  • Footnote:
  • Description: <jats:p>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 &lt; 0.001) and 54 versus 88 days (p &lt; 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.</jats:p>