Bortezomib combined with epirubicin and dexamethasone in treatment of multiple myeloma

To study the efficacy and safty of PAD regimen (bortezomib plus epirubicin and dexamethasone) for multiple myeloma (MM). A total of 103 multiple myeloma (MM) patients received PAD regimen for 2 to 10 cycles. PAD regimen consisted of: bortezomib 1.0 to 1.3 mg/m², intravenous injection within 3 seconds on day 1, 4, 8 and 11; epirubicin 9 mg/m², on day 2, 5, 9 and 12; dexamethasone 20 mg, intravenous on day 1, 2, 4, 5, 8, 9, 11 and 12.Every 28 days was considered as a cycle of treatment and therapeutic response and adverse reactions were observed. The total response rate [complete response (CR) + near complete remission (nCR) + partial response (PR) + minimal reaction (MR)] was 88.3% (91/103), effective rate (CR + PR) was 73.8% (76/103). Among the 103 cases, 32 received PD regimen before, of which 23 cases were effectual. The effective rate (CR + PR) was 71.9% (23/32). The most common hematologic adverse reactions were leukopenia, anemia and thrombocytopenia. Non-hematologic adverse reactions were mainly hypodynamia, peripheral neuropathy, diarrhea, constipation, herpes zoster, respiratory infections, dropsy of serous cavity, thrombosis, skin rashes, hemolysis, etc. All of those were recovered after symptomatic treatment or by prolonging the intermittent period of chemotherapy. PAD regimen is safe, effective and tolerable for the treatment of either newly diagnosed or relapse/refractory MM patients. PAD regimen is better than the single medicine bortezomib or PD regimen and should be considered as the first choice in the multiple myeloma treatment.