OBJECTIVE: We investigated the effect of at least two cycles of bortezomib (1.3 mg/m(2) intravenously, days 1, 4, 8, and 11) after dose-reduced allogeneic stem cell transplantation (SCT) on toxicity, CD3(+) cells, graft-versus-host disease (GvHD), and response in patients with multiple myeloma. METHODS: Eighteen patients with multiple myeloma without progressive disease were included. The proteasome inhibitor was given at median of 8 months after allografting to enhance or maintain remission status. RESULTS: Fourteen patients (78%) completed the proposed two cycles. Four patients had to discontinue therapy due to neurotoxicity (n = 3) or gastrointestinal toxicity (n = 1). Severe grade III/IV toxicity was seen for thrombocytopenia (50%), leukopenia (17%), or neuropathy (17%), which was more often seen in patients treated concomitantly with cyclosporine (p = 0.06). The median circulating CD3(+) cells decreased during treatment from 550 muL to 438 muL (p = 0.03), resulting in herpes zoster infection in three patients (17%). In three patients, a mild aggravation of existing acute or chronic GvHD of the skin, and in one patient de novo skin grade I acute GvHD was noted. In patients with measurable disease, complete remission, partial remission, and minor response was seen in 3 (30%), 5 (50%), and 2 (20%) patients, respective. CONCLUSION: Bortezomib after allogeneic SCT is effective but further studies are needed to balance the efficacy with potential hazards such as infectious complications, aggravation of GvHD, and neurotoxicity.
OBJECTIVE: We investigated the effect of at least two cycles of bortezomib (1.3 mg/m(2) intravenously, days 1, 4, 8, and 11) after dose-reduced allogeneic stem cell transplantation (SCT) on toxicity, CD3(+) cells, graft-versus-host disease (GvHD), and response in patients with multiple myeloma. METHODS: Eighteen patients with multiple myeloma without progressive disease were included. The proteasome inhibitor was given at median of 8 months after allografting to enhance or maintain remission status. RESULTS: Fourteen patients (78%) completed the proposed two cycles. Four patients had to discontinue therapy due to neurotoxicity (n = 3) or gastrointestinal toxicity (n = 1). Severe grade III/IV toxicity was seen for thrombocytopenia (50%), leukopenia (17%), or neuropathy (17%), which was more often seen in patients treated concomitantly with cyclosporine (p = 0.06). The median circulating CD3(+) cells decreased during treatment from 550 muL to 438 muL (p = 0.03), resulting in herpes zoster infection in three patients (17%). In three patients, a mild aggravation of existing acute or chronic GvHD of the skin, and in one patient de novo skin grade I acute GvHD was noted. In patients with measurable disease, complete remission, partial remission, and minor response was seen in 3 (30%), 5 (50%), and 2 (20%) patients, respective. CONCLUSION:Bortezomib after allogeneic SCT is effective but further studies are needed to balance the efficacy with potential hazards such as infectious complications, aggravation of GvHD, and neurotoxicity.
Authors: Damian J Green; David G Maloney; Barry E Storer; Brenda M Sandmaier; Leona A Holmberg; Pamela S Becker; Min Fang; Paul J Martin; George E Georges; Michelle E Bouvier; Rainer Storb; Marco Mielcarek Journal: Blood Adv Date: 2017-11-09
Authors: David H Vesole; Lijun Zhang; Neal Flomenberg; Philip R Greipp; Hillard M Lazarus; Carol A Huff Journal: Biol Blood Marrow Transplant Date: 2009-01 Impact factor: 5.742
Authors: Alex F Herrera; Haesook T Kim; Bhavjot Bindra; Kyle T Jones; Edwin P Alyea; Philippe Armand; Corey S Cutler; Vincent T Ho; Sarah Nikiforow; Bruce R Blazar; Jerome Ritz; Joseph H Antin; Robert J Soiffer; John Koreth Journal: Biol Blood Marrow Transplant Date: 2014-07-10 Impact factor: 5.742
Authors: Marcello Rotta; Barry E Storer; Firoozeh Sahebi; Judith A Shizuru; Benedetto Bruno; Thoralf Lange; Edward D Agura; Peter A McSweeney; Michael A Pulsipher; Parameswaran Hari; Richard T Maziarz; Thomas R Chauncey; Frederick R Appelbaum; Mohamed L Sorror; William Bensinger; Brenda M Sandmaier; Rainer F Storb; David G Maloney Journal: Blood Date: 2008-11-17 Impact factor: 22.113