title: Bortezomib plus dexamethasone induction improves outcome of patients with t(4;14) myeloma but not outcome of patients with del(17p).
abstract: OBJECTIVE
  Cytogenetics is an important prognostic parameter in multiple myeloma (MM). Patients presenting with either t(4;14) or del(17p) are known to have a short event-free survival (EFS) and overall survival (OS). Some preliminary data suggest that bortezomib is able to overcome these prognostic parameters.
  
  
  METHODS
  A series of 507 patients with newly diagnosed MM who received four cycles of bortezomib-dexamethasone induction therapy before high-dose melphalan were analyzed for both t(4;14) and del(17p).
  
  
  RESULTS
  We found that both t(4;14) and del(17p) remain prognostic parameters, even in the context of bortezomib treatment. However, it is important to note that bortezomib significantly improves the prognosis (in terms of both EFS and OS) of patients with t(4;14), compared with patients treated with vincristine, doxorubicin, and dexamethasone induction therapy. In contrast, no improvement was observed for del(17p) patients.
  
  
  CONCLUSIONS
  Short-term bortezomib induction improves outcome of patients with t(4;14) but not the outcome of patients with del(17p). However, both abnormalities remain prognostic factors predicting both EFS and OS despite bortezomib induction.
authors.affiliation: Centre Hospitalier Universitaire, Nantes, France. herve.avetloiseau@chu-nantes.fr
authors.forename: Hervé
authors.initials: H
authors.lastname: Avet-Loiseau
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
authors.forename: Murielle
authors.initials: M
authors.lastname: Roussel
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.forename: Catherine
authors.initials: C
authors.lastname: Guerin-Charbonnel
authors.forename: Denis
authors.initials: D
authors.lastname: Caillot
authors.forename: Gérald
authors.initials: G
authors.lastname: Marit
authors.forename: Lotfi
authors.initials: L
authors.lastname: Benboubker
authors.forename: Laurent
authors.initials: L
authors.lastname: Voillat
authors.forename: Claire
authors.initials: C
authors.lastname: Mathiot
authors.forename: Brigitte
authors.initials: B
authors.lastname: Kolb
authors.forename: Margaret
authors.initials: M
authors.lastname: Macro
authors.forename: Loïc
authors.initials: L
authors.lastname: Campion
authors.forename: Marc
authors.initials: M
authors.lastname: Wetterwald
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Stoppa
authors.forename: Cyrille
authors.initials: C
authors.lastname: Hulin
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Michel
authors.initials: M
authors.lastname: Attal
authors.forename: Stéphane
authors.initials: S
authors.lastname: Minvielle
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D017024:Chemotherapy, Adjuvant; D002872:Chromosome Deletion; D002883:Chromosomes, Human, Pair 14; D002886:Chromosomes, Human, Pair 17; D002894:Chromosomes, Human, Pair 4; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005602:France; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000601:surgery; D019653:Myeloablative Agonists / Q000008:administration & dosage; D020360:Neoadjuvant Therapy; D011446:Prospective Studies; D011480:Protease Inhibitors / Q000008:administration & dosage; D011719:Pyrazines / Q000008:administration & dosage; D013997:Time Factors; D014178:Translocation, Genetic; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D001897:Boronic Acids; D019653:Myeloablative Agonists; D011480:Protease Inhibitors; D011719:Pyrazines; D014750:Vincristine; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin; D008558:Melphalan