INTRODUCTION: Patients with light chain myeloma frequently have a light chain tubular cast nephropathy, which can lead to severe renal impairment. In the present retrospective study, bortezomib was combined with other active substances like bendamustine and prednisone (BPV), in order to assess the efficacy and toxicity of the combination therapy in patients with light chain multiple myeloma. METHODS: Between September 2008 and May 2015, 25 patients with newly diagnosed light chain multiple myeloma were treated with bendamustine 60 mg/m2 on days 1 and 2, bortezomib 1.3 mg/m2 on days 1, 4, 8 and 11, and prednisone 100 mg on days 1, 2, 4, 8 and 11 once every 21 days (BPV). Prior to treatment, 4 patients (16%) had moderate renal dysfunction and 14 patients (56%) severe renal dysfunction or renal failure/dialysis. RESULTS: The median number of the BPV cycles was 2 (1-5). 24 patients (96%) responded with 4 stringent complete responses, 6 near-complete responses, 5 very good partial responses and 9 partial responses. The myeloma light chains decreased rapidly, reaching the best response after the first cycle in 9 and after the second cycle in additional 12 patients. 17 patients discontinued therapy after median 2 cycles of BPV treatment to receive autologous or allogeneic SCT. All together 12 of 18 patients with at least moderate renal failure improved their renal function. 3 of the 6 dialysis-dependent patients became dialysis-independent. With a median follow-up of 27 months, median progression-free survival and overall survival for patients at 30 months were 68 and 96%, respectively. The most common severe side effect was grade 3/4 leukocytopenia in 20% of the patients. Grade 3/4 thrombocytopenia was observed in 12% of the patients. Moderate to severe infection were seen in six patients. We conclude that BPV is effective and well tolerated in patients with newly diagnosed/untreated light chain multiple myeloma.
INTRODUCTION:Patients with light chain myeloma frequently have a light chain tubular cast nephropathy, which can lead to severe renal impairment. In the present retrospective study, bortezomib was combined with other active substances like bendamustine and prednisone (BPV), in order to assess the efficacy and toxicity of the combination therapy in patients with light chain multiple myeloma. METHODS: Between September 2008 and May 2015, 25 patients with newly diagnosed light chain multiple myeloma were treated with bendamustine 60 mg/m2 on days 1 and 2, bortezomib 1.3 mg/m2 on days 1, 4, 8 and 11, and prednisone 100 mg on days 1, 2, 4, 8 and 11 once every 21 days (BPV). Prior to treatment, 4 patients (16%) had moderate renal dysfunction and 14 patients (56%) severe renal dysfunction or renal failure/dialysis. RESULTS: The median number of the BPV cycles was 2 (1-5). 24 patients (96%) responded with 4 stringent complete responses, 6 near-complete responses, 5 very good partial responses and 9 partial responses. The myeloma light chains decreased rapidly, reaching the best response after the first cycle in 9 and after the second cycle in additional 12 patients. 17 patients discontinued therapy after median 2 cycles of BPV treatment to receive autologous or allogeneic SCT. All together 12 of 18 patients with at least moderate renal failure improved their renal function. 3 of the 6 dialysis-dependent patients became dialysis-independent. With a median follow-up of 27 months, median progression-free survival and overall survival for patients at 30 months were 68 and 96%, respectively. The most common severe side effect was grade 3/4 leukocytopenia in 20% of the patients. Grade 3/4 thrombocytopenia was observed in 12% of the patients. Moderate to severe infection were seen in six patients. We conclude that BPV is effective and well tolerated in patients with newly diagnosed/untreated light chain multiple myeloma.
Authors: M A Dimopoulos; M Roussou; M Gkotzamanidou; N Nikitas; E Psimenou; D Mparmparoussi; C Matsouka; M Spyropoulou-Vlachou; E Terpos; E Kastritis Journal: Leukemia Date: 2012-07-05 Impact factor: 11.528
Authors: María-Victoria Mateos; Albert Oriol; Laura Rosiñol; Felipe de Arriba; Noemí Puig; Jesús Martín; Joaquín Martínez-López; María Asunción Echeveste; Josep Sarrá; Enrique Ocio; Gemma Ramírez; Rafael Martínez; Luis Palomera; Angel Payer; Rebeca Iglesias; Javier de la Rubia; Adrian Alegre; Ana Isabel Chinea; Joan Bladé; Juan José Lahuerta; Jesús-F San Miguel Journal: Haematologica Date: 2015-04-24 Impact factor: 9.941
Authors: James R Berenson; Ori Yellin; Alberto Bessudo; Ralph V Boccia; Stephen J Noga; Donald S Gravenor; Dipti Patel-Donnelly; Robert S Siegel; Tarun Kewalramani; Edward J Gorak; Youram Nassir; Regina A Swift; Debra Mayo Journal: Br J Haematol Date: 2012-11-15 Impact factor: 6.998
Authors: Meletios A Dimopoulos; Paul G Richardson; Rudolf Schlag; Nuriet K Khuageva; Ofer Shpilberg; Efstathios Kastritis; Martin Kropff; Maria T Petrucci; Michel Delforge; Julia Alexeeva; Rik Schots; Tamás Masszi; Maria-Victoria Mateos; William Deraedt; Kevin Liu; Andrew Cakana; Helgi van de Velde; Jesús F San Miguel Journal: J Clin Oncol Date: 2009-10-26 Impact factor: 44.544
Authors: Wolfram Pönisch; Malvina Bourgeois; Barbara Moll; Simone Heyn; Nadja Jäkel; Ina Wagner; Robert Rohrberg; Hans-Jürgen Hurtz; Marion Schmalfeld; Michael Aßmann; Thomas Edelmann; Martin Mohren; Franz Albert Hoffmann; Cornelia Becker; Andreas Schwarzer; Uta Schönfelder; Thomas Zehrfeld; Gerald Hensel; Kerstin Löschcke; Rainer Krahl; Haifa Al Ali; Dietger Niederwieser Journal: J Cancer Res Clin Oncol Date: 2012-11-25 Impact factor: 4.553
Authors: Tanja Holzhey; Wolfram Pönisch; Song-Yau Wang; Madlen Holzvogt; Bruno Holzvogt; Marc Andrea; Thomas Zehrfeld; Doreen Hammerschmidt; Franz Albert Hoffmann; Cornelia Becker; Andreas Schwarzer; Maik Schwarz; Uta Schönfelder-Fricke; Thomas Edelmann; Leanthe Braunert; Georg-Nikolaus Franke; Madlen Jentzsch; Sebastian Schwind; Markus Bill; Juliane Grimm; Yvonne Remane; Uwe Platzbecker; Markus Scholz Journal: J Cancer Res Clin Oncol Date: 2021-01-12 Impact factor: 4.553