Second Department of Hematology, Langfang Traditional Chinese Medicine Hospital, Langfang, 065000, China , hengshuilyq@126.com
Abstract: (630 Views)
Background:To evaluate factors influencing the clinical efficacy of radiotherapy combined with the Yishenhuoxue detoxification (YSHX-D) method and the bortezomib-lenalidomide-dexamethasone (VRD) regimen in multiple myeloma (MM). Materials and Methods: From February 2021 to November 2022, 100 MM patients were enrolled in the Department of Hematology and Oncology at Langfang Traditional Chinese Medicine Hospital. Diagnosis was confirmed through bone marrow examination and immunological index analysis. Patients were randomly assigned to two groups (n=50 each). The observation group received radiotherapy with YSHX-D plus VRD, while the control group received radiotherapy with VRD alone. Radiotherapy was delivered to symptomatic bone lesions to relieve pain and stabilize disease progression. Clinical indicators included M protein, immunoglobulins, haemoglobin, platelets, and white blood cells. Treatment response was assessed per International Myeloma Working Group (IMWG) criteria. Results: Both groups achieved pain relief and slowed lesion progression with radiotherapy. The observation group demonstrated higher response rates than the control group, with greater reductions in M protein and immunoglobulins and improvements in haemoglobin and platelet counts (P<0.05). Logistic regression identified disease stage, age, genetic factors, and immune status as independent predictors of treatment efficacy. Conclusion: Radiotherapy combined with YSHX-D and VRD is safe and effective for MM, especially for managing skeletal complications. Patient-specific factors significantly influence outcomes, underscoring the need for individualized treatment strategies.
1. 1. Bal S, Landau HJ, Shah GL, et al. (2020) Stem cell mobilization and autograft minimal residual disease negativity with novel induction regimens in multiple myeloma. Biol Blood Marrow Transplant, 26: 1394-401. [DOI:10.1016/j.bbmt.2020.04.011]
2. Chari A, Rodriguez-Otero P, McCarthy H, et al. (2021) Subcutaneous daratumumab plus standard treatment regimens in patients with multiple myeloma across lines of therapy (PLEIADES): an open-label phase II study. Br J Haematol, 192: 869-78. [DOI:10.1111/bjh.16980]
3. He J, Schmerold L, Van Rampelbergh R, et al. (2021) Treatment pattern and outcomes in newly diagnosed multiple myeloma patients who did not receive autologous stem cell transplantation: a real-world observational study. Adv Ther, 38: 640-59. [DOI:10.1007/s12325-020-01546-0]
4. Combariza JF, Ordúz R, Agudelo C, et al. (2022) Incidence and prognostic significance of high-risk cytogenetic abnormalities in multiple myeloma patients in Colombia. Clin Lymphoma Myeloma Leuk, 22: 601-7. [DOI:10.1016/j.clml.2022.02.006]
5. Ohno S, Hayashi K, Shimizu R, et al. (2022) Addition of bortezomib to high-dose cyclophosphamide therapy as a conditioning regimen for autologous peripheral blood stem cell harvest leads to an increased yield of hematopoietic stem cells. J Clin Exp Hematop, 62: 147-53. [DOI:10.3960/jslrt.22013]
6. Erath A, Patel DA, Hosack EA, et al. (2020) Overcoming proteasome inhibitor-refractory multiple myeloma with elotuzumab, bortezomib, nelfinavir, and dexamethasone. World J Oncol, 11: 33-6. [DOI:10.14740/wjon1241]
7. Dreyfuss A, Fregonese B, Ma J, Sarkar RR, Cederquist G, Usmani SZ, et al. (2023) Recent Patterns of Radiotherapy Use in Multiple Myeloma: Clinical Outcomes and Possible Radiologic, Biochemical, and Genomic Correlates of Response. Blood, 142(1): 6648-. [DOI:10.1182/blood-2023-188172]
8. Marneni N and Chakraborty R (2021) Current approach to managing patients with newly diagnosed high-risk multiple myeloma. Curr Hematol Malig Rep,16: 148-61. [DOI:10.1007/s11899-021-00631-7]
9. Botta C, Gigliotta E, Paiva B, et al. (2022) Network meta-analysis of randomized trials in multiple myeloma: efficacy and safety in frontline therapy for patients not eligible for transplant. Hematol Oncol, 40: 987-98. [DOI:10.1002/hon.3041]
10. Kraeber-Bodéré F, Jamet B, Bezzi D, Zamagni E, Moreau P, Nanni C (2023) New developments in myeloma treatment and response assessment. J Nuclear Medicine, 122: 264972. [DOI:10.2967/jnumed.122.264972]
11. Dai Y, Zhou Y, Chen H (2025) Synergistic mechanisms of traditional chinese medicine and proteasome inhibitors in multiple myeloma therapy: A comprehensive review. Drug Design, Development and Therapy, 19(null): 7099-109. [DOI:10.2147/DDDT.S531815]
12. Huang C-Y, Wu M-Y, Kuo Y-H, Tou S-I, Yen H-R (2020) Chinese herbal medicine is helpful for survival improvement in patients with multiple myeloma in Taiwan: A nationwide retrospective matched-cohort study. Integrative Cancer Therapies, 19: 1534735420943280. [DOI:10.1177/1534735420943280]
13. Byun JM, Park SS, Yoon SS, et al. (2023) Advantage of achieving deep response following frontline daratumumab-VTd compared to VRd in transplant-eligible multiple myeloma: multicenter study. Blood Res, 58: 83-90. [DOI:10.5045/br.2023.2023005]
14. Davies F, Rifkin R, Costello C, et al. (2021) Real-world comparative effectiveness of triplets containing bortezomib, carfilzomib, daratumumab, or ixazomib in relapsed/refractory multiple myeloma in the US. Ann Hematol, 100: 2325-37. [DOI:10.1007/s00277-021-04534-8]
15. Facon T, San-Miguel J, Dimopoulos MA, et al. (2022) Treatment regimens for transplant-ineligible patients with newly diagnosed multiple myeloma: a systematic literature review and network meta-analysis. Adv Ther, 39: 1976-92. [DOI:10.1007/s12325-022-02083-8]
16. Gaballa MR, Ma J, Tanner MR, et al. (2022) Real-world long-term outcomes in multiple myeloma with VRD induction, Mel200-conditioned auto-HCT, and lenalidomide maintenance. Leuk Lymphoma, 63: 710-21. [DOI:10.1080/10428194.2021.1992763]
17. Narsipur N, Bulla S, Yoo C, et al. (2021) Cost-effectiveness of adding daratumumab or bortezomib to lenalidomide plus dexamethasone for newly diagnosed multiple myeloma. J Manag Care Spec Pharm, 27: 1691-702. [DOI:10.18553/jmcp.2021.27.12.1691]
18. Katodritou E, Kastritis E, Dalampira D, et al. (2023) Improved survival of patients with primary plasma cell leukemia with VRd or daratumumab-based quadruplets: a multicenter study by the Greek myeloma study group. Am J Hematol, 98: 730-8. [DOI:10.1002/ajh.26891]
19. Moreau P, Hebraud B, Facon T, et al. (2021) Front-line daratumumab-VTd versus standard-of-care in ASCT-eligible multiple myeloma: matching-adjusted indirect comparison. Immunotherapy, 13: 143-54. [DOI:10.2217/imt-2020-0266]
20. Cheng L, Guan L, Xu Y, et al. (2021) Potential effect of epigenetic drugs in the treatment of multiple-site extramedullary plasmacytoma involving the respiratory system: a case report and review of the literature. Transl Cancer Res, 10: 4262-73. [DOI:10.21037/tcr-21-68]
21. Huo Z, Chen F, Liu P, et al. (2023) Ixazomib combined with lenalidomide and dexamethasone chemotherapy for newly diagnosed multiple myeloma in China: compared with bortezomib/lenalidomide/dexamethasone. Cancer Med, 12: 2937-44. [DOI:10.1002/cam4.5198]
22. Ding X, Ding J, Gu H, et al. (2022) Long-acting granulocyte colony-stimulating factor in primary prophylaxis of early infection in patients with newly diagnosed multiple myeloma. Support Care Cancer, 30: 4049-54. [DOI:10.1007/s00520-022-06851-8]
23. Okazuka K, Ishida T, Nashimoto J, et al. (2020) The efficacy and safety of modified bortezomib-lenalidomide-dexamethasone in transplant-eligible patients with newly diagnosed multiple myeloma. Eur J Haematol, 104:110-5. [DOI:10.1111/ejh.13349]
24. Medhekar R, Ran T, Fu AZ, Patel S, Kaila S (2022) Real-world patient characteristics and treatment outcomes among nontransplanted multiple myeloma patients who received Bortezomib in combination with Lenalidomide and Dexamethasone as first line of therapy in the United States. BMC Cancer, 22(1): 901. [DOI:10.1186/s12885-022-09980-9]
25. Cook J, Johnson I, Higgins A, et al. (2021) Outcomes with different administration schedules of bortezomib in bortezomib, lenalidomide, and dexamethasone (VRd) as first-line therapy in multiple myeloma. Am J Hematol, 96: 330-7. [DOI:10.1002/ajh.26074]
26. Kaufman JL, Mina R, Shah JJ, et al. (2020) Phase 1 trial evaluating vorinostat plus bortezomib, lenalidomide, and dexamethasone in patients with newly diagnosed multiple myeloma. Clin Lymphoma Myeloma Leuk, 20: 797-803. [DOI:10.1016/j.clml.2020.07.013]
27. Paiva B, Puig N, Cedena MT, et al. (2020) Measurable residual disease by next-generation flow cytometry in multiple myeloma. J Clin Oncol, 38: 784-92. [DOI:10.1200/JCO.19.01231]
28. Al Hadidi S, Ababneh OE, Schinke CD, Thanendrarajan S, Bailey C, Smith R, et al. (2024) Three years of maintenance with VRD in multiple myeloma: results of total therapy IIIB with a 15-year follow-up. Blood Advances, 8(3): 703-7. [DOI:10.1182/bloodadvances.2023011601]
29. Cheng L, Zhang F, Li Z, Zhuang J, Cai H, Li H (2024) The role of next-generation sequencing in predicting early relapse for newly diagnosed multiple myeloma patients treated with VRD regimen. Blood, 144: 6856. [DOI:10.1182/blood-2024-210092]
30. Lionetti M, Scopetti M, Matera A, Maeda A, Marella A, Lazzaroni F, et al. (2025) Clonal hematopoiesis is clonally unrelated to multiple myeloma and is associated with specific microenvironmental changes. Blood, 146(5): 571-84. [DOI:10.1182/blood.2024026236]
Wang M, Li Y, Gao E, Zhou Y, Fan H, Zhou Z, et al . Influencing Factors on the clinical effect of yishenhuoxue detoxification method combined with bortezomib-lenalidomide-dexamethasone (VRD) regimen and radiotherapy in the treatment of multiple myeloma. Int J Radiat Res 2026; 24 (2) :391-396 URL: http://ijrr.com/article-1-7016-en.html