Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients: A retrospective case‐matched study

American Journal of Hematology, Wiley, ISSN 1096-8652

Volume 89, 4, 2014

DOI:10.1002/ajh.23641, Dimensions: pub.1028745845, PMID: 24273190,



  1. (1) UOC Ematologia Torino Italy
  2. (2) Division of Hematology Myeloma Unit Torino Italy
  3. (3) Haga Hospital, grid.413591.b
  4. (4) Complejo Hospitalario de Salamanca, grid.411258.b
  5. (5) University of Copenhagen, grid.5254.6, KU
  6. (6) A.O. Ordine Mauriziano – Umberto I SCDU Ematologia e Terapie Cellulari Torino Italy
  7. (7) VU University Medical Center, grid.16872.3a
  8. (8) Hospital Universitario 12 De Octubre, grid.144756.5
  9. (9) Hematology and Clinical Immunology Padova University School of Medicine Department of Clinical and Experimental Medicine Padova Italy
  10. (10) IRCCS, Referral Cancer Centre of Basilicata Department of Onco‐Haematology Italy
  11. (11) Medisch Spectrum Twente, grid.415214.7
  12. (12) Institut Català d'Oncologia, Hospital Germans Trias i Pujol Clinical Hematology Badalona Spain
  13. (13) Stem Cell Center, Lund University, and Skåne University Hospital Department of Hematology Lund Sweden
  14. (14) University of Naples Federico II, grid.4691.a
  15. (15) Hospital Clínico Universitario de Valencia, grid.411308.f
  16. (16) University of Perugia, grid.9027.c
  17. (17) Ospedale Ferrarotto, Universtà di Catania Divisione di Ematologia Catania Italy
  18. (18) University of Eastern Piedmont Amadeo Avogadro, grid.16563.37
  19. (19) Divisione di Medicina Nucleare 2 AO Città della Salute e della Scienza di Torino Italy
  20. (20) Registro Tumori Regione Piemonte AO Città della Salute e della Scienza di Torino Italy
  21. (21) Ankara University, grid.7256.6
  22. (22) University of Bologna, grid.6292.f
  23. (23) Norwegian University of Science and Technology, grid.5947.f
  24. (24) Hospital Universitario de Salamanca, CIC, IBMCC (USAL‐CSIC) Servicio de Hematología Spain
  25. (25) Erasmus Medical Center Rotterdam The Netherlands
  26. (26) Azienda Ospedaliero Universitaria Ospedali Riuniti, grid.411490.9


Novel agents in combination with melphalan and prednisone (MP) significantly improved progression-free survival (PFS) and overall survival (OS) in multiple myeloma (MM). Randomized trials comparing MP plus bortezomib (VMP) versus MP plus thalidomide (MPT) are lacking. Nine hundred and fifty-six elderly (>65 years) newly diagnosed MM patients from six European randomized trials were retrospectively analyzed and matched for age, albumin, and beta2-microglobulin at diagnosis, 296 patients were selected from the VMP groups, and 294 from MPT. Complete response rate was 21% in the VMP patients and 13% in the MPT patients (P = 0.007). After a median follow-up of 34 months (range, 1-92), VMP significantly prolonged both PFS (median 32.5 vs. 22.9 months, HR 0.65; 95% CI 0.52-0.82; P < 0.001) and OS (median 79.7 vs. 45.1 months, HR 0.44; 95% CI 0.32-0.59; P < 0.001) in comparison with MPT. The benefit in terms of OS of the VMP group was quite similar among patients with different risk factors defined by sex, ISS, ECOG performance status, or serum creatinine but not among patients ≥ 75 years. Multivariate analysis confirmed that VMP was an independent predictor of longer PFS and OS. In a control-case matched analysis, PFS and OS were prolonged in patients who received VMP in comparison with those treated with MPT.

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