High efficacy and safety of VTD as an induction protocol in patients with newly diagnosed multiple myeloma eligible for high dose therapy and autologous stem cell transplantation: A report of the Polish Myeloma Study Group

Abstract

The present retrospective analysis evaluated the efficacy and safety of the VTD (bortezomib, thalidomide, dexamethasone) regimen in 205 newly-diagnosed patients with multiple myeloma (MM) eligible for high dose therapy and autologous stem cell transplantation (HDT/ASCT) in routine clinical practice. With a median of 6 cycles (range, 1–8), at least partial response was achieved in 94.6% and at least very good partial response (VGPR) was achieved in 67.8% of patients. Peripheral neuropathy (PN) grade 2–4 was observed in 28.7% of patients. In 72% of patients undergoing stem cell mobilization one apheresis allowed the number of stem cells sufficient for transplantation to be obtained. Following HDT/ASCT the sCR rate increased from 4.9 to 14.4% and CR from 27.8 to 35.6%. The results demonstrated that VTD as an induction regimen was highly efficient in transplant eligible patients with MM with increased at least VGPR rate following prolonged treatment (≥6 cycles). Therapy exhibited no negative impact on stem cell collection, neutrophils and platelets engraftment following ASCT. Therapy was generally well tolerated and PN was the most common reason of dose reduction or treatment discontinuation.

Kinase Inhibition in Multiple Myeloma: Current Scenario and Clinical Perspectives

“…When eligible for HSCT, patients are submitted to one of two induction regimens: VTD, which includes bortezomib, thalidomide, and dexamethasone, or VRD, which includes bortezomib, lenalidomide, and dexamethasone, being the most adopted pre-transplant induction regimens available [42]. The role of induction chemotherapy is to reduce the neoplastic burden at the patient's BM in order to increase response rates and effectiveness of an autologous transplantation graft [43][44][45][46].…”

Current status and achievements of Polish haemato-oncology

“…One of the original clinical protocols was the evaluation of the efficacy and safety of multiple myeloma (MM) patient therapy with the CTD regimen (cyclophosphamide, thalidomide, and dexamethasone) based on a low dose of thalidomide (100 mg/d) [60]. Other clinical and multicentre studies of the PMSG were focused on therapy with lenalidomide, pomalidomide and bortezomib as well as the identification of novel cytogenetic prognostic factors [61][62][63][64][65][66].…”