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Ǵм Yeungnam Univ J Med 2018;35(1):76-83


Chemotherapy adherence is a favorable prognostic factor for elderly patients with multiple myeloma who are treated with a frontline bortezomib-containing regimen

Hee-Jeong Cho1*, Sang-Kyung Seo1*, Dong Won Baek1, Sung-Woo Park1, Yoo-Jin Lee1, Sang-Kyun Sohn1, Ho-Sup Lee2, Won Sik Lee3, Ji Hyun Lee4, Sung Hyun Kim
1Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu; 2Department of Hematology/Oncology,
Kosin University Gospel Hospital, Busan; 3Department of Hematology-Oncology, Inje University Pusan Baik Hospital, Busan;
4Department of Hematology-Oncology, Dong-A University Hospital, Busan, Korea
Corresponding Author: Joon-Ho Moon, Department of Hematology/Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu 41944, Korea Tel: +82-53-200-6314, Fax: +82-53-426-2046
Tel: +82-53-200-6314, Fax: +82-53-426-2046
E-mail: jhmoon@knu.ac.kr

Received: April 31, 2018, Revised: June 8, 2018 Accepted: June 8, 2018


Background: Elderly patients with multiple myeloma (MM) are vulnerable to adverse events (AEs). This study evaluated adherence to chemotherapy and treatment outcomes in elderly patients treated with a frontline bortezomib (BTZ), melphalan, and prednisone (VMP) regimen and regimens without BTZ. Methods: One-hundred and forty elderly patients who were diagnosed with MM from March 2007 to March 2015 were included in this retrospective study. To evaluate regimen adherence, patients who were treated with more than 4 cycles were assigned to the good adherence group. Results: Among the 140 patients, 71 were treated with a frontline VMP and 69 with non-BTZ regimens. The median age was 71 years (range, 65-90 years). The VMP group showed a higher complete response rate than the non-BTZ group: 26.8% vs. 7.2%. More patients in the VMP group achieved very good partial response (VGPR) and PR. In the VMP group, 27 patients (38.0%) received less than 4 cycles. The VMP good adherence group showed a higher 3-year overall survival (OS) rate (70.9%) than the poor adherence group (60.2%, p=0.059). In the multivariate analysis, treatment with 4 cycles of VMP was a favorable factor for OS. Conclusion: A good adherence to a frontline VMP regimen resulted in favorable long-term survival. Adequate management of AEs will be needed to achieve favorable outcomes in elderly patients with MM.

Key Words: Keywords: Multiple myeloma; Bortezomib; Elderly; Medication adherence