title: Bortezomib (Velcade) for progressive myeloma after autologous stem cell transplantation and thalidomide.
abstract: Twenty-one patients with multiple myeloma, all relapsed after frontline autologous stem cell transplantation and all relapsed again after or resistant to thalidomide (employed as second line treatment) received bortezomib (1.3 mg/m(2) body surface twice weekly for 2 weeks followed by an interval of 10-12 days) without adjunct of steroids as third line therapy. Three patients died of progressive disease during the first 2 cycles with bortezomib. Eighteen patients received at least 2 cycles and were evaluated for response. According to EBMT criteria, two complete (negative immunofixation) and seven partial (reduction of M-component > 50-75%) remissions were achieved (ITT response rate 42.8%). Duration of response lasted from 2 to 14+ months. Grades 3-4 toxicities (thrombocytopenia, leucopenia, peripheral neuropathy and vasculitis) were observed in seven patients, but no patient interrupted the treatment due to side effects. We conclude that bortezomib alone may induce high quality responses as third line salvage therapy with acceptable toxicity in a significant proportion of homogeneously pre-treated myeloma patients with progressive disease after autologous transplantation and thalidomide.
authors.affiliation: Unit of Hematology and Stem Cell Transplantation, IRCCS Casa Sollievo della Sofferenza Hospital, S. Giovanni Rotondo, Italy. p.musto@tin.it
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Antonietta
authors.initials: A
authors.lastname: Falcone
authors.forename: Grazia
authors.initials: G
authors.lastname: Sanpaolo
authors.forename: Tommasina
authors.initials: T
authors.lastname: Guglielmelli
authors.forename: Renato
authors.initials: R
authors.lastname: Zambello
authors.forename: Enrico
authors.initials: E
authors.lastname: Balleari
authors.forename: Lucio
authors.initials: L
authors.lastname: Catalano
authors.forename: Mauro
authors.initials: M
authors.lastname: Spriano
authors.forename: Federica
authors.initials: F
authors.lastname: Cavallo
authors.forename: Antonio
authors.initials: A
authors.lastname: La Sala
authors.forename: Saverio
authors.initials: S
authors.lastname: Mantuano
authors.forename: Michele
authors.initials: M
authors.lastname: Nobile
authors.forename: Lorella
authors.initials: L
authors.lastname: Melillo
authors.forename: Potito Rosario
authors.initials: PR
authors.lastname: Scalzulli
authors.forename: Matteo
authors.initials: M
authors.lastname: Dell'Olio
authors.forename: Carlo
authors.initials: C
authors.lastname: Bodenizza
authors.forename: Michele Mario
authors.initials: MM
authors.lastname: Greco
authors.forename: Angelo Michele
authors.initials: AM
authors.lastname: Carella
authors.forename: Emanuela
authors.initials: E
authors.lastname: Merla
authors.forename: Angelo Michele
authors.initials: AM
authors.lastname: Carella
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Nicola
authors.initials: N
authors.lastname: Cascavilla
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001897:Boronic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D000069286:Bortezomib; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011719:Pyrazines / Q000008:administration & dosage* / Q000009:adverse effects; D012008:Recurrence; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D013792:Thalidomide / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000209:etiology; D014184:Transplantation, Homologous
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib