Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Oncology (Medical )

Objective: Compare outcome of treatment of Bortezomib-based regimens versus VAD regimen (Vincristine, Doxorubicin, Dexamethazone) in multiple myeloma patients treated in The Medical Oncology departments of both National Cancer Institute (NCI) and Nasser Institute from January 2011 till December 2015). Methods:This study was performed retrospectively on 89 MM patientstreated at The Medical Oncology departments of both National Cancer Institute (NCI) and Nasser Institute from January 2011 till December 2015.All patients were evaluated for different responses with different lines of treatment (VAD versus Bortezomib based regimens) which correlated with progression free survival (PFS) and overall survival (OS). Also, the different prognostic factors: age, sex, clinical presentation, albumin, LDH, creatinine,B2 microglobulin, ISS, Durie Salmon Staging and ASCT which correlated with different lines of treatment, PFS and OS. Results: The age of patients ranged between 32 years to 76 years and the mean age was 51.1+/-7.4 years. It included 65.2% males and 34.8% females with male to female ratio 1.87:1. Bony pains were the most common clinical manifestation of patients in our study (44.9%) followed by bony masses (22.5%), fractures (16.9%), pallor (7.9%), neurological symptoms (5.6%) and finally oliguria (2.2%).Bortezomib based regimens have better overall response rate (ORR)({u2265}PR)( p value 0.031), progression free survival PFS(p value 0.004) and disease free survival DFS(p value 0.013) as 1st line treatment compared to VAD regimen. Also in previously treated patients bortezomib based regimens showed better progression free survival PFS(p value 0.039) compared to VAD regimen. There was significant relation between age (p value 0.001&<0.001) and ASCT (p value 0.001&0.034) with PFS and OS respectively, while other factors was not significant including (sex, clinical presentation, B2 microglobulin, creatinine, LDH, albumin, ISS, Durie Salmon Staging)

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