Superior myeloma response with bortezomib-based regimen in multiple myeloma patients with renal impairment

Objectives: We aimed at retrospectively evaluating the role of bortezomib-based, thalidomide-based, and vincristine-adriamycin-dexamethasone (VAD) regimens on the myeloma response and reversibility of renal insufficiency in 130 consecutive newly diagnosed patients with renal impairment. Methods: Between May 2005 and February 2014, 130 consecutive unselective patients with newly diagnosed multiple myeloma and RI were treated with bortezomib-based, thalidomide-based, and VAD regimen at our institute. Patients were divided into three groups according to the type of different induction regimens. Results: A myeloma response was achieved in 92.4% of patients in group B, in 75% in group T, and in 39.3% in group VAD (P=0.000). A complete recovery of renal function (renal complete response) was observed in 56.1% of patients treated with bortezomib, in 38.9% with thalidomide, and in 28.6% with VAD (P=0.033), a significant improvement of renal function (>= renal PR [ partial response]) was observed in 63.6% of patients treated with bortezomib, in 66.1% with thalidomide, and in 42.9% with VAD (P=0.162). Conclusion: prompt initiation of bortezomib or thalidomide based regimen for newly diagnosed myeloma patients with renal impairment, helps in achieving a rapid effective response rate and high rates of renal recovery.