Effectiveness of arsenious acid combined with CTD chemotherapy in the treatment of relapsed and refractory multiple myeloma

Objective To investigate the therapeutic effect and adverse events of arsenious acid combined with cyclophosphamid, thalidomide and dexamethasone (CTD) chemotherapy in the treatment of relapsed and refractory multiple myeloma (MM). Methods A total of 32 relapsed and refractory MM patients who received arsenious acid combined with CTD chemotherapy were enrolled and their clinical data were retrospectively analyzed. Their overall survival rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), overall survival (OS), and adverse reactions were analyzed. Results All patients were evaluated for their therapeutic effects, with ORR of 50% (16/32) and CBR of 62.5% (20/32). For 15 patients who received arsenious acid combined with CTD chemotherapy due to the presence of progression after bortezomib-based therapy, their ORR was 53.3% (8/15), and CBR was 80.0% (12/15). The median follow-up time of these 32 patients was 10 (3—33) mouths. At the end of follow-up visit, 20 patients survived, and the median PFS and OS was 6.0 (95%CI 4.52—7.48) and 24.0 (95%CI 17.14—30.85), respectively. The main adverse reactions were digestive tract reaction, leukocytopenia, liver function damage, and peripheral neuropathy. Conclusions Arsenious acid combined with CTD chemotherapy is a good choice of treatment for some relapsed and refractory MM patients, and effective for bortezomib resistant MM patients to some extent.