High early mortality rate in elderly patients with multiple myeloma receiving a vincristine-doxorubicin-dexamethasone regimen

Hao Wei Teng, Chung Jen Teng, Wei Shu Wang, Po Min Chen, Tzeon Jye Chiou, Hui Chi Hsu, Jin Hwang Liu, Chueh Chuan Yen, Liang Tsai Hsiao, Muh Hwa Yang, Ta Chung Chao, Ya Hsu Yang, Jyh Pyng Gau

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Treatment-related mortality (TRM) is not uncommon in patients after the first course of vincristine-doxorubicin-dexamethasone (VAD) chemotherapy, but quite rare after melphalan-prednisolone (MP). This motivated us to compare the rates of TRM after the first course of VAD with those after the first course of MP. We retrospectively assessed survival and TRM in 179 patients treated for multiple myeloma with either MP or VAD. Survival was similar in two groups (P = 0.463 in log-rank test). However, TRM was significantly higher in patients after the first course of VAD (11 in 100 patients, 11.0%) than that after the first course of MP (1 in 79, 1.3%; P = 0.010). Poor performance status (P = 0.004) and advanced age (P = 0.009) before treatment were independent significant factors associated with TRM after the first course of induction therapy. Pyogenic infection was the major cause of TRM after VAD (9 in 11, 81.8%). We concluded that VAD should be cautiously used as induction therapy in multiple myeloma patients, especially in elderly and/or those with poor performance status.

Original languageEnglish
Pages (from-to)812-815
Number of pages4
JournalAmerican Journal of Hematology
Volume85
Issue number10
DOIs
Publication statusPublished - Oct 2010
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

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