Table 1.
Brief summary of regimens used during the whole clinical course
| Regimen | Cycles | Date of treatments | FLC-λ(mg/L)/BMG(mg/L) | Evaluation |
|---|---|---|---|---|
| ① VAD | 3 | Jun. 19~Sep.5/2015 | ≥ 3200→1140/6.5→2.2 | Effective |
| ②RMdD | 1 | Sep.14 ~Oct. 4/2015 | 1140→1430/2.2→2.5 | Ineffective |
| ③ RMdD-CAM400 | 7 | Oct. 12~May 15/2016 | 1430→439/2.5→1.5 | Effective |
| ④ sdp BD | 2 | May 16~Jun. 29/2016 | 439→72.9/1.5→1.3 | Effective |
| ⑤ BRedD | 2 | Jul. 11~Sep. 6/2016 | 72.9→496/1.3→1.5 | Ineffective |
| ⑥ PD | 1 | Sep. 13~Oct. 3/2016 | 496→805/1.5→1.9 | Ineffective |
| ⑦ sdpBD | 1 | Oct. 17~Oct. 30/2016 | 805→267/1.9→1.6 | Fairly effective |
| ⑧ VAD | 1 | Nov. 14~Dec. 6/2016 | 267→323/1.6→1.4 | Ineffective |
| ⑨sdpBD-CAM800 | 2 | Dec. 12~Jan. 23/2017 | 323→24.9/1.4→1.1 | Very effective |
| ⑩sdpB-CAM800 | 1 | Feb. 4~Feb. 26/2017 | 24.9→148/1.1→2.1 | Ineffective |
| ⑪ sdpBRMd-cam800 | 4 | Feb. 27~May 8/2017 | 148→12.9/2.8→2.1 | Very effective |
| ⑫ sdpBRedRMd-CAM800 | 6 | May 23~Oct. 31/2017 | 12.9→14.2/2.1→1.4 | Effective/stable |
A (ADM) adriamycin, B bortezomib, BMG ß2-microglobulin, CAM clarithromycin, D (Dex) dexamethasone, FLC free light chain, Md minimized-dose, P (Pom) pomalidomide, R Revlimid (Len: lenalidomide), Red reduced dose, sc subcutaneous, sdp short dosing-period, V vincristine, wk week
① VAD: V 0.4 mg/body·ADM 9 mg/m2, continuous intravenous infusion, on days 1–4; Dex 40 mg/body, on days1–4, 9–12, 17–20, every 4-wk cycle
②RMdD: Len 10 mg/day for 3 wks; Dex 20 mg/day, twice/week for 3 wks, every 4-wk cycle
③RMdD-CAM400: RMdD combined with CAM 400 mg/day, 200 mg twice/day for 3 wks, every 4-wk cycle
④ sdpBD: Bor 1.3 mg/m2, sc, twice/wk for 2 wks; Dex 20 mg/day twice/wk for 2 wks, every 4-wk cycle
⑤ BRedD: Bor 1.3 mg/m2, sc, once/wk for 4 wks; Dex 20 mg/day, twice/wk for 4 wks, every 6-wk cycle
⑥ PD: Pom 4 mg/day for 3 wks; Dex 20 mg/day twice/wk for 3 wks, every 4-wks cycle
⑦ sdpBD ⑧VAD
⑨ sdpBD-CAM800: sdpBD combined with CAM 800 mg/day, 400 mg twice/day for 2 wks, every 4-wk cycle
⑩sdpB-CAM800: Bor 1.3 mg/m2, sc, twice/wk for 2 wk; CAM 800 mg/day, 400 mg twice/day for 2 wks, every 4-wk cycle
⑪sdpBRMd-CAM800: Bor 1.3 mg/m2, sc, twice/wk for 2 wks; Len 10 mg/day for 2 wks; CAM 800 mg/day, 400 mg twice/day for 2 wks, every 4-wk cycle
⑫sdpBRedRMd-CAM800: Bor 1.3 mg/m2, sc, once/wk for 2 wks; Len 10 mg/day for 2 wks; CAM 800 mg/day, 400 mg twice/day for 2 wks, every 4-wk cycle