or ub ic in , ▁and ▁de x am eth as one ▁or ▁the ▁V C MP ▁reg imen ▁of ▁v inc rist ine , ▁car must ine , ▁mel phal an , ▁and ▁pred nis one ▁altern ating ▁with ▁v inc rist ine , ▁car must ine , ▁do x or ub ic in , ▁and ▁pred nis one . ▁The ▁treatment ▁of ▁P CL ▁patients , ▁particularly ▁p P CL ▁patients , ▁with ▁newer ▁methods ▁appears ▁to ▁have ▁made ▁mod est ▁improvements ▁in ▁surv ival ▁rates . ▁However , ▁the ▁r ar ity ▁of ▁these ▁two ▁le uk em ias ▁has ▁limited ▁individual ▁studies ▁to ▁case ▁reports ▁on ▁a ▁small ▁number ▁of ▁patients ▁or ▁rect ros pective ▁anal ys es ▁of ▁patient ▁records . ▁Random ized ▁controlled ▁tri als ▁on ▁these ▁patients ▁have ▁not ▁been ▁reported . ▁One ▁f law ▁of ▁these ▁methods ▁is ▁patient ▁selection ▁bias , ▁i . e . ▁patients ▁selected ▁for ▁treatment ▁with ▁a ▁new ▁reg imen ▁may ▁be ▁less ▁ill ▁than ▁average ▁patients ▁with ▁the ▁disease ▁and ▁therefore ▁have ▁an ▁intr ins ically ▁less ▁ag gress ive ▁( i . e . ▁longer ▁overall ▁surv ival ▁time ) ▁disease . ▁ ▁Primary ▁pl asma ▁cell ▁le uk emia ▁ ▁Rec ent ▁case ▁report ▁studies ▁suggest ▁that ▁treatment ▁reg im ens ▁which ▁include ▁a ▁prote as ome ▁in hib itor ▁drug , ▁particularly ▁bor te z om ib , ▁and / or ▁aut olog ous ▁stem - cell ▁trans plant ation ▁have ▁improved ▁p P CL ▁surv