Document Detail


Optimizing the use of anti-interleukin-6 monoclonal antibody with dexamethasone and 140 mg/m2 of melphalan in multiple myeloma: results of a pilot study including biological aspects.
MedLine Citation:
PMID:  16113665     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Interleukin-6 (IL-6) is a major survival factor for multiple myeloma (MM) cells preventing apoptosis induced by dexamethasone (DEX) or chemotherapy. In all, 24 consecutive patients with MM in first-line therapy received DEX for 4 days, followed by melphalan (HDM: 140 mg/m2) and autologous stem cell transplantation (ASCT). The anti-IL-6 monoclonal antibody (mAb) (B-E8) was given till haematological recovery, starting 1 day before DEX. Results were historically compared to MM patients treated with HDM 140 and 200 mg/m2. Our results show (1) that B-E8 was able to fully neutralize IL-6 activity in vivo before and after HDM as shown by inhibition of C reactive protein (CRP) production; (2) no haematological toxicity; (3) a significant reduction of mucositis and fever; (4) a median event-free survival of 35 months and an overall survival of 68.2% at 5 years with a median follow-up of 72 months; and (5) the overall daily IL-6 production progressively increased on and after 7 days post-HDM, with the increased serum CRP levels. In the 5/24 patients with uncontrolled CRP production, a large IL-6 production was detected (320 microg/day) that could not possibly be neutralized by B-E8. These data show the feasibility to neutralize IL-6 in vivo with anti-IL-6 mAb in the context of HDM.
Authors:
J-F Rossi; N Fegueux; Z Y Lu; E Legouffe; C Exbrayat; M-C Bozonnat; R Navarro; E Lopez; P Quittet; J-P Daures; V Rouillé; T Kanouni; J Widjenes; B Klein
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  36     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-17     Completed Date:  2006-01-10     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  771-9     Citation Subset:  IM    
Affiliation:
Service d'Hématologie et d'Oncologie Médicale, CHU Montpellier, avenue du Doyen Giraud, Montpellier Cédex, France. jf-rossi@chu-montpellier.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Inflammatory Agents / administration & dosage*
Antibodies, Monoclonal / administration & dosage*,  immunology
C-Reactive Protein / analysis
Dexamethasone / administration & dosage*
Disease-Free Survival
Drug Evaluation
Female
Humans
Interleukin-6* / blood,  immunology
Male
Melphalan / administration & dosage*
Middle Aged
Mucositis / etiology,  mortality
Multiple Myeloma / blood,  complications,  mortality,  therapy*
Myeloablative Agonists / administration & dosage*
Pilot Projects
Stem Cell Transplantation* / methods
Transplantation, Autologous
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Interleukin-6; 0/Myeloablative Agonists; 148-82-3/Melphalan; 50-02-2/Dexamethasone; 9007-41-4/C-Reactive Protein
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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