OBJECTIVE: To explore the clinical efficacy of three-drug combination regimen containing low-dose bortezomib in the treatment of elderly multiple myeloma. METHODS: A total of 100 elderly patients（≥60 years） with multiple myeloma admitted into our hospital from Sept. 2016 to Dec. 2019 were randomly divided into the observation group（n=49） and the control group（n=51） according to different medication regimen. Both groups were given bortezomib

thalidomide（100 mg/d

orally

from the 1 st to the 28 th day） and dexamethasone（20 mg/d

from the 1 st to the 2 nd

4 th to 5 th

8 th to 9 th

and 11 th to 12 th day）. The observation group was given bortezomib 0.7 mg/m~2 on the 1 st

4 th

8 th and 11 th day

while the control group received bortezomib 1.3 mg/m~2 on the 1 st

4 th

8 th and 11 th day. One course of treatment was 28 d. Blood routine

immune function

thymidine kinase 1（TK1） and lactate dehydrogenase（LDH） levels were compared between two groups before treatment and after treatment of 3 courses. Differences of clinical efficacy

occurrence of adverse drug reactions and long-term survival indicators were compared. RESULTS: After treatment

the levels of serum CD4

+

T cells and natural killer cells in two groups were significantly higher than those before treatment

the levels of CD8

+

T cells and Treg cells were significantly lower than those before treatment

and the levels of myeloma cells

TK1 and LDH were significantly lower than those before treatment

the differences were statistically significant（P

<

0.05）; there was no significant difference between two groups after treatment（P

>

0.05）. The total effective rate of the observation group was 46.94%（23/49）

and that of the control group was 60.78%（31/51）

with no statistically significant difference（P=0.228）. There was no significant difference in overall survival rate between two groups（P

>

0.05）. However

the incidence of adverse drug reactions such as herpes zoster

peripheral neuropathy and gastrointestinal reactions was lower in the observation group

and the difference was statistically significant compared with the control group（P

<

0.05）. CONCLUSIONS: Compared with the standard dose of bortezomib

the three-drug combination regimen containing low-dose bortezomib has similar clinical effects in the treatment of elderly multiple myeloma

and the incidence of adverse drug reactions such as peripheral neuropathy and gastrointestinal reactions decrease significantly

and can significantly improve the blood routine

immune function

reduce the tumor burden with higher safety.