Efficacy and Safety of Pegylated Liposomal Doxorubicin, Vincristine, and Reduced-dose Dexamethasone (DVd) Combination Therapy for Newly Diagnosed Multiple Myeloma and Refractory or Relapsed Multiple Myeloma Patients in Pharmongkutklao Hospital: A Preliminary Report

บทคัดย่อ

Objective: To assess a response rate, safety and tolerability of pegylated liposomal Doxorubicin, vincristine, and reduced-dose Dexamethasone (DVd) combination therapy in newly diagnosed and refractory or relapsed multiple myeloma  patients. Method: Eight newly diagnosed and 2 relapsed/refractory multiple myeloma patients at Phramongkutklao  hospital were enrolled to receive DVd every 4 weeks/cycle for 3 or 6 cycles during July 2006 to December  2007 and evaluated for response after 3 cycles. Results: The overall response rate in new cases was 75% (6/8):  complete response and very good partial response (CR+VGPR) 25% (2/8) and partial response (PR) 50% (4/8). No patient discontinue the treatment due to adverse events. Thecommont oxicityw asn eutropeniag rade1 a nd
2. Non-hematologic toxicities were infections, peripheral neuropathy and mucositis. Cardiotoxicity, alopecia, skin
infection w ereu ncommona ndn op almar-plantare rythrodysesthesiaw asr eportedi nt hiss tudy. Conclusions: This
preliminary  study suggested that the DVd regimen had similar efficacy as VAD regimen in newly diagnosed MM,
while  the overall toxicities were not increased. Furthermore, it could reduce hospitalization day due to the outpatient
administrations. However, combination with newer agents may be required for relapsed/refractory cases. More
studies  in Thai myeloma patient should be done to confirm this result.