Bortezomib plus dexamethasone induction improves outcome of patients with t(4;14) myeloma but not outcome of patients with del(17p).
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.
Avet-Loiseau
Hervé
H
Centre Hospitalier Universitaire, Nantes, France. herve.avetloiseau@chu-nantes.fr
Leleu
Xavier
X
Roussel
Murielle
M
Moreau
Philippe
P
Guerin-Charbonnel
Catherine
C
Caillot
Denis
D
Marit
Gérald
G
Benboubker
Lotfi
L
Voillat
Laurent
L
Mathiot
Claire
C
Kolb
Brigitte
B
Macro
Margaret
M
Campion
Loïc
L
Wetterwald
Marc
M
Stoppa
Anne-Marie
AM
Hulin
Cyrille
C
Facon
Thierry
T
Attal
Michel
M
Minvielle
Stéphane
S
Harousseau
Jean-Luc
JL
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
D001897:Boronic Acids; D019653:Myeloablative Agonists; D011480:Protease Inhibitors; D011719:Pyrazines; D014750:Vincristine; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin; D008558:Melphalan