[Adverse effects of PAD and VAD regimens in multiple myeloma patients]

Area of Science:

• Oncology
• Pharmacology
• Hematology

Background:

• Multiple myeloma (MM) is a hematologic malignancy.
• Chemotherapy regimens like bortezomib + adriamycin + dexamethasone (PAD) and vincristine + adriamycin + dexamethasone (VAD) are used for MM treatment.
• Evaluating the comparative adverse effects of different chemotherapy regimens is crucial for patient management.

Purpose of the Study:

• To compare the adverse effects of PAD and VAD chemotherapy regimens in multiple myeloma patients.
• To identify specific toxicities associated with each regimen and their incidence.
• To assess the impact of these adverse events on treatment continuation.

Main Methods:

• A comparative study involving 27 patients in the PAD group and 30 patients in the VAD group.
• Patients received 3-5 cycles of either PAD or VAD chemotherapy.
• Adverse reactions, their type, severity, and timing were systematically observed and recorded.

Main Results:

• Both PAD and VAD regimens caused adverse effects including leucocytopenia, thrombocytopenia, peripheral neuropathy, infection, fatigue, nausea, and corticosteroid-related effects.
• Rash was observed exclusively in the PAD group.
• The incidence of thrombocytopenia was statistically higher in the PAD group. Higher incidences of leucocytopenia, peripheral neuropathy, and infection were also noted in the PAD group compared to VAD.
• Treatment discontinuation was primarily due to infection and peripheral neuropathy, with more cases in the PAD group.

Conclusions:

• The PAD regimen may offer improved therapeutic effects for multiple myeloma but is associated with potentially more severe toxicities than the VAD regimen.
• Adverse effects like rash, constipation, and peripheral neuropathy can occur early in treatment, while others emerge later.
• Careful monitoring and management of toxicities are essential when using the PAD regimen in multiple myeloma patients.