Clinical value of absolute lymphocyte counts before bortezomib-dexamethasone therapy in relapsed multiple myeloma patients.
A high absolute lymphocyte count (ALC) at diagnosis is known as a surrogate marker of favorable prognosis in newly diagnosed multiple myeloma (MM). Recent studies showed tumor sensitization and enhanced cytotoxicity of bortezomib. We hypothesized that a high ALC before bortezomib treatment would contribute to tumor sensitization and activated cytotoxicity of bortezomib in relapsed MM. Ninety-seven relapsed MM patients who underwent bortezomib-dexamethasone (Vel-Dex) therapy were analyzed. Median follow-up duration was 21 months and median age was 61 years. Complete response (CR) and very good partial response (VGPR) after 2 cycles of Vel-Dex therapy were higher in the high-ALC group (>or=1.1 x 10(9)/l) (CR + VGPR 50.0% in the high-ALC group vs. 10.4% in the low-ALC group, p = 0.001), and stable disease (SD) rate was lower in the high-ALC group (SD 11.8% in the high-ALC group vs. 44.8% in the low-ALC group, p < 0.001). In the univariate analysis, the low-ALC group before therapy was associated with shorter progression-free survival (PFS) [hazard ratio (HR), 2.780; 95% confidence interval (95% CI) 1.703-4.536, p < 0.001]. Multivariate analysis revealed that a low ALC represented an independent predictive factor for PFS (HR 1.937, 95% CI 1.168-3.212, p = 0.010). A low ALC just before Vel-Dex therapy was associated with a poor prognosis in relapsed MM.
Song
Moo-Kon
MK
Departments of Hematology-Oncology, Busan National Cancer Center, Pusan National University Hospital Medical Research Institute, Seo-gu, Busan, Republic of Korea.
Chung
Joo-Seop
JS
Joo
Young-Don
YD
Lee
Sang-Min
SM
Lee
Gyeong-Won
GW
Lee
Ho-sup
HS
Kim
Sung-Hyun
SH
Yun
Eun-Young
EY
Seol
Young-Mi
YM
Kim
Seung-Geun
SG
Shin
Ho-Jin
HJ
Choi
Young-Jin
YJ
Cho
Goon-Jae
GJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D003907:Dexamethasone / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011719:Pyrazines / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy
D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone