Gemcitabine in Treating Patients with Refractory or Relapsed Multiple Myeloma

Background: Patients with refractory or relapsed multiple myeloma are considered to have a very poorprognosis, and new regimens are needed to improve the outcome. Gemcitabine, a nucleoside antimetabolite, isan analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongationand depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemicanalysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with refractory andrelapsed multiple myeloma.
Methods: Clinical studies evaluating the impact of gemcitabine based regimenson response and safety for patients with refractory and relapsed multiple myeloma were identified by using apredefined search strategy. Pooled response rate (RR) of treatment were calculated.
Results: In gemcitabine basedregimens, 3 clinical studies which including 57 patients with refractory and relapsed multiple myeloma wereconsidered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 15.7% (9/57)in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia,leucopenia and thrombocytopenia i. No treatment related death occurred with gemcitabine based treatment.
Conclusion: This systemic analysis suggests that gemcitabine based regimens are associated with mild activitywith good tolerability in treating patients with refractory or relapsed multiple myeloma.