The VACD-Thal Protocol in the Treatment of Multiple Myeloma in Abidjan (Côte D’ivoire)

Abstract

Background:The new drugs currently used in the treatment of myeloma are available in Africa but inaccessible because of their high cost. That's why treatment of multiple myeloma remains a challenge in our sector. Objective:To evaluate the VACD-Thal protocol in the treatment of myeloma in Côte d'Ivoire. Materials and Methods:It's was a prospective and descriptive study with duration of two years at the department of clinical hematology in Côte d'Ivoire. We included the patients with multiple myeloma, diagnosed according to the IMWG 2015 criteria, treated and follow with protocol VACD-Thal. The variables analysed were demographic, paraclinical, therapeutic and evolutionary data. Survival curves were plotted using the Kaplan Meier method. Results:We included 33 patients. There were 22 men (66.7%) and 11 women (33.3%). The average age was 60.5 years with extremes of 42 and 79 years. 24.2% of patients worked in industrial enterprises and 24.24% were exposed to herbicides and pesticides. HIV and arterial hypertension were the comorbidities. The symptoms were dominated by deteriorisation of general state (63.3%), bone pain (48.5%), pathological fractures (18.2%), anemia (93.9%) and hypercalcemia (45.4%). The typical myeloma was predominant (81.8%). Our patients were classified ISS III in 78.8% of case. The overall therapeutic response was observed in 84.8% of cases with a very good partial response in 63.64% of cases and a partial response in 21.2% of cases. Overall survival at 6 months was 87% and 88.5% at one year of survival. Conclusion:Combination of immunomodulator with conventional chemotherapy such as VACD-Thal protocol has done the better results compared to chemotherapy alone.