Objective To observe the therapeutic effect and safety of bortezomib, dexamethasone combined with lenalidomide (VRD) schemes and bortezomib, dexamethasone combined with cyclophosphamide (VCD) schemes in multiple myeloma patients, so as to provide reference for clinical practice. Methods The clinical data of 60 patients with multiple myeloma admitted to Yancheng No.1 People’s Hospital from January 2020 to December 2022 were retrospectively analyzed. According to different treatment schemes, they were divided into VRD group and VCD group, with 30 cases in each group. The treatment efficacy, levels of various biochemical indicators, levels of T lymphocyte subpopulations, and incidence of adverse reactions were compared between the two groups. Results The overall curative effect of VRD group was better than that of VCD group, and the overall remission rate was higher than that of VCD group (P<0.05). After treatment, serum M protein, plasma cell ratio in bone marrow and β2-microglobulin levels of patients in two groups were lower than those before treatment, the hemoglobin levels was higher than that before treatment, and the serum M protein, plasma cell ratio in bone marrow and β2-microglobulin levels in the VRD group were lower than those in the VCD group, while hemoglobin levels were higher than the VCD group (P<0.05). After treatment, the percentage of CD4+T lymphocytes and the ratio of CD4+/CD8+ of patients in two groups were higher than those before treatment, while the percentage of CD8+T lymphocytes was lower than before treatment, and the percentage of CD4+T lymphocytes and the ratio of CD4+/CD8+ in the VRD group were higher than those in the VCD group, and the percentage of CD8+T lymphocytes was lower than that in the VCD group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion VRD schemes has a significant effect in the treatment of multiple myeloma, which can significantly optimize the biochemical indicators of the body, improve immune function, and has good safety.