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Bone Marrow Transplant. 2014 Nov;49(11):1371-5. doi: 10.1038/bmt.2014.165. Epub 2014 Aug 4.

Bortezomib improves outcome after SCT in multiple myeloma patients with end-stage renal failure.

Author information

1
1] Max-Eder-Group 'Experimental Therapies for Hematologic Malignancies', Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany [2] Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany.
2
Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
3
Division of Nephrology, Heidelberg University Hospital, Heidelberg, Germany.
4
Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany.
5
1] Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany [2] Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
6
1] Max-Eder-Group 'Experimental Therapies for Hematologic Malignancies', Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany [2] Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.

Abstract

Patients with multiple myeloma and dialysis-dependent renal failure have dismal outcomes. In this retrospective analysis of a case series, we evaluated 27 consecutive patients, all of whom required haemodialysis at the time of first-line induction therapy with either bortezomib or a standard regimen followed by high-dose chemotherapy and auto-SCT. The overall response rate was significantly better after bortezomib-based induction before auto-SCT (83% vs 36%, P=0.02) and at day +100 post auto-SCT (100% vs 58%, P=0.01). Bortezomib also prolonged EFS and furthermore, a trend towards a shorter time on haemodialysis was observed in the bortezomib group at a median of 6.1 months (0.2-68.2 months) vs 17.1 months (0.7-94.3 months, P=0.38) in patients who had received vincristine, adriamycin, dexamethasone or vincristine, adriamycin, dexamethasone-like induction regimens. These data demonstrate the superior efficacy of bortezomib-based induction therapy in transplant-eligible patients with end-stage renal failure.

PMID:
25089594
DOI:
10.1038/bmt.2014.165
[Indexed for MEDLINE]

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