Efficiency and tolerability of induction and consolidation therapy with arsenic trioxide/ bortezomib/ascorbic acid/dexamethasone (ABCD) regimen compared to bortezomib/ dexamethasone (BD) regimen in newly diagnosed myeloma patients

Abstract

This study was aimed at comparing the efficacy and tolerability of an arsenic trioxide/ bortezomib/ascorbic acid/dexamethasone (ABCD) regimen with efficacy and tolerability of a bortezomib/dexamethasone (BD) regimen in patients with newly diagnosed myeloma. Patients and Methods: Fifty-seven and sixty-four patients were treated with the ABCD and BD regimens, respectively. Eligible and agreeable patients received autologous hematopoietic stem cell transplantation followed by consolidation. Results: The response rates (above VGPR) were 74.1% and 32.8% in the ABCD-and BDtreated groups, respectively (P = 0.000). Compared to BD regimen, ABCD regimen significantly improved PFS (P = 0.026) and OS (P = 0.000) in newly diagnosed patients. Patients with a high tumor burden, low or standard risk, and without auto-HSCT seemed to especially benefit compared to the same group with BD regimen. ABCD also showed better tolerability with lower bone marrow suppression (P = 0.026). Furthermore, complete response or near CR after induction therapy was a good prognostic factor for ABCDassociated OS and PFS. Conclusion: ABCD is an effective and tolerable regimen compared with BD regimen in newly diagnosed myeloma patients. ABCD regimen could be an economical, effective, and tolerable choice in low-and standard-risk patients.