Bortezomib and the increased incidence of herpes zoster in patients with multiple myeloma.
BACKGROUND
Bortezomib has significantly advanced the treatment of patients with multiple myeloma (MM). However, considering that most patients with MM are elderly, bortezomib-related morbidity should be thoroughly studied to ensure the safe use of this drug. Herpes zoster has been reported as a possible adverse event associated with bortezomib because a major target of bortezomib, nuclear factor-kappaB, is known to be involved with T-cell immunity.


METHODS
We performed a retrospective analysis of the incidence of herpes zoster among 282 patients treated with a bortezomib-containing regimen.


RESULTS
During the patients' pre-bortezomib treatment (median, 2.14 years), the incidence of herpes zoster was 11% (31 of 282 patients). However, after the patients were treated with bortezomib, the incidence increased to 22.3% (63 of 282 patients), of which almost all occurrences were within the first 3 cycles (median duration, 41 days). The time interval from diagnosis to bortezomib initiation date was shorter in herpes zoster-positive patients than in herpes zoster-negative patients (2.14 +/- 1.87 years vs. 3.38 +/- 2.95 years; P = .002). Disease duration, previous herpes zoster infection, disease stage and type of myeloma, and the type and intensity of previous treatments failed to show any relationship with herpes zoster. These findings suggest that longer history of disease and treatments did not affect the occurrence of herpes zoster, nor did the type of bortezomib regimens or their toxicities.


CONCLUSIONS
Bortezomib can increase the incidence of herpes zoster regardless of disease duration, previous treatments, and concomitantly administered drugs. Thus, the occurrence of herpes zoster should be monitored during bortezomib treatment.
Kim
Seok Jin
SJ
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
Kim
Kihyun
K
Kim
Byung Soo
BS
Lee
Hyo-Jin
HJ
Kim
Hawk
H
Lee
Na-Ri
NR
Nam
Seung-Hyun
SH
Kwon
Jung Hye
JH
Kim
Hyo Jung
HJ
Sohn
Sang Kyun
SK
Won
Jong-Ho
JH
Lee
Jae Hoon
JH
Suh
Cheolwon
C
Yoon
Sung-Soo
SS
Kim
Hye Jin
HJ
Kim
Inho
I
Do
Young-Rok
YR
Lee
Won-Sik
WS
Joo
Young-Don
YD
Shin
Ho Jin
HJ