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Clin Lymphoma Myeloma Leuk. 2014 Oct;14(5):389-94. doi: 10.1016/j.clml.2014.02.004. Epub 2014 Feb 18.

Patterns of relapse or progression after bortezomib-based salvage therapy in patients with relapsed/refractory multiple myeloma.

Author information

  • 1Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Republic of Korea.
  • 2Department of Hematology-Oncology, St Carollo Hospital, Suncheon-si, Jeollanam-do, Republic of Korea.
  • 3Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Republic of Korea. Electronic address: drjejung@chonnam.ac.kr.

Abstract

INTRODUCTION:

Bortezomib-based therapy is commonly used in treatment for relapsed or refractory multiple myeloma (MM). Unfortunately, many patients show relapse or progression in heterogeneous patterns.

PATIENTS AND METHODS:

In this study, we retrospectively evaluated patterns of relapse or progression after bortezomib-based salvage therapy in patients with MM and analyzed prognostic significance according to patterns of relapse or progression. One hundred forty-eight patients were treated with bortezomib-based therapy between November 2004 and April 2012. Of these patients, 104 (70.3%) patients relapsed or progressed after bortezomib-based salvage therapy. We divided the patterns of relapse or progression to the 2 groups: (1) the isoform relapse or progression (group A) in 89 (85.6%) patients as disease findings at initiation of bortezomib-based therapy; and (2) transformed relapse or progression (group B) in 15 (14.4%) patients (plasmacytoma, n = 7; light chain escape, n = 6; and plasma cell leukemia, n = 2) different from initial disease findings.

RESULTS:

Median overall survival in group A and group B were 32.7 months (95% confidence interval [CI], 21.3-44.1) and 10.7 months (95% CI, 2.0-19.4) (P < .001), respectively.

CONCLUSION:

MM patients who relapsed or progressed as the transformed pattern for bortezomib-based salvage therapy have an extremely poor prognosis and might require new innovative approaches.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Clonal evolution; Free light chain; Light chain escape; Plasma cell leukemia; Plasmacytomas

PMID:
24630919
[PubMed - in process]
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