Abstract
Multiple myeloma (MM) is a common hematological malignancy. The high efficacy of the VTD induction regimen (bortezomib, thalidomide, dexamethasone) is limited by dose-dependent adverse reactions of thalidomide.
Objective. To evaluate the effect of a thalidomide dose-escalation strategy in the VTD regimen on efficacy and safety in patients with newly diagnosed MM.
Materials and methods. In a single-center prospective study (n=93; 2018–2025), patients received VTD with thalidomide dose escalation from 50 mg/day to 100 mg/day. Response was assessed according to IMWG criteria.
Results. The overall response rate was 78.5% (95.7% in evaluable patients). The main dose-limiting reactions were constipation (32.3%) and rash (23.7%), with a low incidence of neuropathy (9.7%). The target dose was received by 58.1% of patients. A direct correlation was found between thalidomide dose intensity and depth of response (p<0.001). Median progression-free survival was not reached.
Conclusion. The dose-escalation strategy of thalidomide in the VTD regimen demonstrates high efficacy and acceptable tolerability. Maintaining a high dose through toxicity management is associated with a better response.
Keywords: hemoblastosis, multiple myeloma, thalidomide, bortezomib, adverse reactions.
For citation:Al-Nsour J.M., Kaliberdenko V.B., Ablaeva A.R., Dodo E.S., Suhtaeva A.I., Osmanova M.O., Korshenkova Ju.A., Abibulaeva S.S. Bortezomib in combination with thalidomide and dexamethasone in patients with newly diagnosed multiple myeloma: evaluation of efficacy and safety in real clinical practice Clinical review for general practice. 2026; 7 (7): 62–65 (In Russ.). DOI: 10.47407/kr2026.7.7.00887
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