title: Response to bortezomib is associated to osteoblastic activation in patients with multiple myeloma.
abstract: The prompt response to bortezomib observed in a 63-year-old woman with multiple myeloma was associated with a significant increase in alkaline phosphatase (ALP). After similar elevations were noted in patients responding to bortezomib, thalidomide, dexamethasone combination, ALP levels were analysed in two large bortezomib trials. A statistically significant elevation of ALP from baseline was observed in responding patients (complete and partial responders) within three cycles of therapy. The rise in ALP after bortezomib in three patients was explained by a parallel increase in bone-specific ALP and parathyroid hormone, suggesting that response to bortezomib in myeloma is closely associated with osteoblastic activation.
authors.affiliation: The Myeloma Institute for Research and Therapy, The University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. zangarimaurizio@uams.edu
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zangari
authors.forename: Dixie
authors.initials: D
authors.lastname: Esseltine
authors.forename: Choon-Kee
authors.initials: CK
authors.lastname: Lee
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
authors.forename: Francesca
authors.initials: F
authors.lastname: Elice
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Burns
authors.forename: Seung-Hee
authors.initials: SH
authors.lastname: Kang
authors.forename: Shmuel
authors.initials: S
authors.lastname: Yaccoby
authors.forename: Kevin
authors.initials: K
authors.lastname: Najarian
authors.forename: Paul
authors.initials: P
authors.lastname: Richardson
authors.forename: Peter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Guido
authors.initials: G
authors.lastname: Tricot
mesh_terms: D000469:Alkaline Phosphatase / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D002454:Cell Differentiation; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D010006:Osteoblasts / Q000378:metabolism / Q000473:pathology; D010281:Parathyroid Hormone / Q000378:metabolism; D011480:Protease Inhibitors / Q000627:therapeutic use*; D011719:Pyrazines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D010281:Parathyroid Hormone; D011480:Protease Inhibitors; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone; D000469:Alkaline Phosphatase