Jornal de Hematologia e Doenças Tromboembólicas
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Once-weekly Bortezomib in Combination with Reduced-dose Dexamethasone and Continuous Low-dose Oral Cyclophosphamide for Elderly Patients with Multiple Myeloma

Hideo Yagi, Aki Fujii, Syuji Minamoto, Mariko Fujita, Keiko Yamazaki, Hitoshi Hanamoto and Kazuo Tsubaki

CyBorD is one of the most effective triplet regimens for both transplant-eligible and ineligible patients with multiple myeloma. In comparison, once-weekly bortezomib induction therapy with a reduced dosage of dexamethasone (modified-CyBorD) showed less toxicity but an equally high response rate. However, this modification still resulted in bortezomib-induced PN in more than half of patients. We therefore introduced a once-weekly schedule of bortezomib combined with continuous low-dose oral cyclophosphamide and reduced dosage of dexamethasone (reduced-CyBorD) in transplantineligible patients with multiple myeloma in our hospital. A total of 32 patients, including 20 who were newly diagnosed and 12 who were refractory/resistant, were treated with reduced-CyBorD, and the regimen’s efficacy and safety were evaluated. The median age was 72 years; 17 patients were male and 15 were female. The overall response rate was 90.6% with 43.8% complete response/near complete response. The median progression-free and overall survival was 14.9 months and 43 months, respectively. Three patients (9.4%) developed grade 1 peripheral neuropathy, and no patients had to reduce or discontinue bortezomib. In conclusion, our results suggested that this reduced combination therapy might be a safe and effective approach in transplant-ineligible patients with multiple myeloma.