Bortezomib: friend or foe of hemolytic anemia?
Over the last decade, bortezomib moved in a stepwise fashion from a benchside promise into a bedside reality and is currently an important tool in the treatment of plasma cell disorders. This review focuses on the relationship between bortezomib and hemolytic anemia. In animal models with lupus-like disease, this agent was shown to deplete the auto-reactive plasma cells and serum autoantibody levels. In humans, two isolated reports advocate the efficacy of bortezomib in autoimmune hemolytic anemia, but important concerns remain with data interpretation and length bias. Conversely, bortezomib may be causative of hemolytic anemia, as reported in a cohort of patients with chronic lymphocytic leukemia [corrected]. Concerted efforts of both basic and clinical researchers are necessary to further explore the safety and efficacy of this agent in nonmalignant disorders, including autoimmune disorders and anemias.
Dasanu
Constantin A
CA
Department of Hematology-Oncology, St. Francis Hospital and Medical Center, Hartford, CT, USA. c_dasanu@yahoo.com
D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000188:drug therapy* / Q000201:enzymology / Q000276:immunology; D000818:Animals; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000188:drug therapy* / Q000201:enzymology / Q000276:immunology; D001897:Boronic Acids / Q000009:adverse effects*; D000069286:Bortezomib; D019317:Evidence-Based Medicine; D006801:Humans; D011480:Protease Inhibitors / Q000009:adverse effects*; D046988:Proteasome Endopeptidase Complex / Q000378:metabolism; D061988:Proteasome Inhibitors; D011719:Pyrazines / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors
D001897:Boronic Acids; D011480:Protease Inhibitors; D061988:Proteasome Inhibitors; D011719:Pyrazines; D000069286:Bortezomib; D046988:Proteasome Endopeptidase Complex; C061553:ATP dependent 26S protease