关键词: 多发性骨髓瘤, t(11;14), 硼替佐米, 来那度胺

Abstract: Objective To examine the differences in therapy response and confirm the effective regimen for multiple myeloma (MM) patients with t (11; 14)/CD20^- or CD20⁺, for the selection of transplantation as early treatment. Methods To find the differences in therapy response and to confirm the effective regimen for multiple myeloma (MM) patients with t (11; 14)/CD20^- or CD20⁺, for the selection of transplantation as the early treatment. There were three cytogenetics groups: t(11; 14)/CD20^- or CD20⁺ and low-risk profile including normal or cytogenetics other than t (11; 14). Eligible patients received the bortezomib-based induction and lenalidomide-based consolidation/maintenance regimen. Results Patients with t(11;14) gained adverse therapy response for bortezomib induction regimen than other low-risk arm (OR rate: 11.1% versus 84.0% versus 85.2%, P＜0.01). A prospective found that although the patients with t(11;14)/CD20^- showed the poor overall response for the bortezomib-based regimen, lenalidomide-based treatment schedule makes them gain a similar therapy advantage comparing with t(11;14)/ CD20⁺ and other low-risk group in the study The subgroup analyses of progression-free survival(PFS) and overall survival(OS) by continued lenalidomide-based consolidation/maintenance treatment also showed a benefit for lenalidomide therapy compared with observation regardless of cytogenetic risk profile and response at baseline (PFS at 4 years reached 75.0% versus 77.1% versus 84.2%, OS at 4 years was 75.0% versus 88.5% versus 90.4%, respectively). Moreover, the lenalidomide regimen little induced the incidence of fatal complications and was tolerated. There were only 3.2%, 8.4% and 15.8% patients had agranulocytosis, peripheral neuropathy and infection of 3-4 grade. Conclusions Lenalidomide regimen is more effective for t (11, 14)/ CD20^- risk MM and t(11;14)/CD20⁺ and other cytogenetically low-risk MM are consistent in PFS and OS. In addition, the initial response rate of MM patients with unsatisfactory bortezomib treatment can also be improved.

Key words: multiple myeloma, t(11;14), bortezomib, lenalidomide