Abstract

To analyze the effects of bortezomib on the prognosis of the newly-diagnosed multiple myeloma patients with renal impairment, newly-diagnosed multiple myeloma patients with renal impairment (serum creatinine [Scr] ≥178 μmol/L) were studied in Beijing Chaoyang Hospital. According to the regimen with or without bortezomib, the patients were divided into two groups: bortezomib group (n=25) and non-bortezomib group (n=38). The outcomes of the combination therapies were evaluated. There were 63 patients who could be evaluated. The remission rate (complete remission (CR), very good partial remission (VGPR) and partial remission (PR)) of bortezomib group was higher than that of non-bortezomib group (70.8% versus 47.2%, P<0.01) especially the CR rate and VGPR rate (16.7% versus 5.6% and 25.0% versus 11.1%). There was no significant difference on the time to reversing renal function (1.4 months versus 1.5 months, P>0.05). But the ration of renal function reversal in patients with bortezomib-combined regimen was statistically higher than that of classical chemotherapy without bortezomib (79.2% versus 50%, P<0.05). The 2-year overall survival rate of bortezomib group was 69.0%, but the non-bortezomib group was 34.0%. Patients in the bortezomib group were superior to the patients in the non-bortezomib group by Kaplan-Meier analysis (P=0.041). The main toxicities in the bortezomib group included thrombocytopenia, peripheral neuropathy (PN), infection, Herpes Zoster, etc., and there was a low incidence of grade 3 and 4 adverse events. The bortezomib-based combination chemotherapy can improve the prognosis of the newly-diagnosed multiple myeloma patients with renal impairment and may become the front-line therapy for these patients.

Key words: Multiple myeloma, bortezomib, renal impairment, prognosis.