Abstract
Between April 2006 and June 2009, 34 newly diagnosed patients with multiple myeloma received one to three courses of bortezomib 1.3 mg/m(2) i.v. four times, lenalidomide 25 mg p.o. daily for 21 days and dexamethasone 20 mg/m(2) p.o. for 4 days beginning on days 1, 9 and 17 (BLD). There was rapid onset of remission in 30 patients (88%) similar to the frequency of 87% induced by a previous combination of bortezomib-thalidomide-dexamethasone (BTD). After a median of 3.6 months, 28 patients received intensive therapy with high-dose melphalan supported by autologous blood stem cells, so that the overall frequency of complete remission (CR) was 44%, similar to the frequency of 37% observed previously. Side effects due to thalidomide with previous BTD were less frequent and severe with BLD. The combination of BLD given for one or two courses was an effective primary treatment for newly diagnosed patients with multiple myeloma.
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Boronic Acids / administration & dosage
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Boronic Acids / adverse effects
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Bortezomib
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Combined Modality Therapy
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Dexamethasone / administration & dosage
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Dexamethasone / adverse effects
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Drug Evaluation
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Female
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Hematologic Diseases / chemically induced
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Humans
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Lenalidomide
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Male
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Melphalan / therapeutic use
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Middle Aged
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Multiple Myeloma / drug therapy*
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Multiple Myeloma / surgery
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Nervous System Diseases / chemically induced
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Peripheral Blood Stem Cell Transplantation
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Pyrazines / administration & dosage
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Pyrazines / adverse effects
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Remission Induction
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Retrospective Studies
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Thalidomide / administration & dosage
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Thalidomide / adverse effects
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Thalidomide / analogs & derivatives
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Time Factors
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Transplantation, Autologous
Substances
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Boronic Acids
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Pyrazines
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Thalidomide
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Bortezomib
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Dexamethasone
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Lenalidomide
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Melphalan