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Administration of bortezomib before and after autologous stem-cell transplantation improves outcome in multiple myeloma patients with deletion 17p.
MedLine Citation:
PMID:  22160383     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In patients with Multiple Myeloma (MM), risk stratification by chromosomal abnormalities may enable a more rational selection of therapeutic approaches. Here we analyzed the prognostic value of 12 chromosomal abnormalities in a series of 354 MM patients treated within the HOVON-65/GMMG-HD4 trial. Because of the two-arm design of the study, we were able to analyze the effect of a bortezomib-based treatment before and after autologous stem-cell transplantation (arm B) in comparison to standard treatment without bortezomib (arm A). For all analyzed chromosomal aberrations, progression free survival (PFS) and overall survival (OS) were at least equal or superior in the bortezomib-arm as compared to the standard arm. Strikingly, patients with del(17p13) benefitted most from the bortezomib-containing treatment (median PFS time: A: 12.0 months, B: 26.2 months, p=0.024; 3yr-OS rates: A: 17%, B: 69%, p=0.028). After multivariate analysis, del(17p13) was an independent predictor for PFS (p<0.0001) and OS (p<0.0001) in arm A, whereas no statistical significant effect on PFS (p=0.28) and OS (p=0.12) was seen in arm B. In conclusion, the adverse impact of del(17p13) on PFS and OS could be significantly reduced by the bortezomib-based treatment, suggesting that long-term administration of bortezomib should be recommended for patients carrying del(17p13). This trial is registered at ISRCTN as ISRCTN64455289.
Authors:
Kai Neben; Henk M Lokhorst; Anna Jauch; Uta Bertsch; Thomas Hielscher; Bronno van der Holt; Hans Salwender; Igor W Blau; Katja Weisel; Michael Pfreundschuh; Christof Scheid; Ulrich Dührsen; Walter Lindemann; Ingo Gh Schmidt-Wolf; Norma Peter; Christian Teschendorf; Hans Martin; Mathias Haenel; Hans G Derigs; Marc S Raab; Anthony D Ho; Helgi van de Velde; Dirk Hose; Pieter Sonneveld; Hartmut Goldschmidt
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-8
Journal Detail:
Title:  Blood     Volume:  -     ISSN:  1528-0020     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany;
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