title: Administration of bortezomib before and after autologous stem cell transplantation improves outcome in multiple myeloma patients with deletion 17p.
abstract: In patients with multiple myeloma (MM), risk stratification by chromosomal abnormalities may enable a more rational selection of therapeutic approaches. In the present study, we analyzed the prognostic value of 12 chromosomal abnormalities in a series of 354 MM patients treated within the HOVON-65/GMMG-HD4 trial. Because of the 2-arm design of the study, we were able to analyze the effect of a bortezomib-based treatment before and after autologous stem cell transplantation (arm B) compared with standard treatment without bortezomib (arm A). For allanalyzed chromosomal aberrations, progression-free survival (PFS) and overall survival (OS) were at least equal or superior in the bortezomib arm compared with the standard arm. Strikingly, patients with del(17p13) benefited the most from the bortezomib-containing treatment: the median PFS in arm A was 12.0 months and in arm B it was 26.2 months (P = .024); the 3 year-OS for arm A was 17% and for arm B it was 69% (P = .028). After multivariate analysis, del(17p13) was an independent predictor for PFS (P < .0001) and OS (P < .0001) in arm A, whereas no statistically significant effect on PFS (P = .28) or OS (P = .12) was seen in arm B. In conclusion, the adverse impact of del(17p13) on PFS and OS could be significantly reduced by bortezomib-based treatment, suggesting that long-term administration of bortezomib should be recommended for patients carrying del(17p13).
authors.affiliation: Department of Internal Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany. kai.neben@med.uni-heidelberg.de
authors.forename: Kai
authors.initials: K
authors.lastname: Neben
authors.forename: Henk M
authors.initials: HM
authors.lastname: Lokhorst
authors.forename: Anna
authors.initials: A
authors.lastname: Jauch
authors.forename: Uta
authors.initials: U
authors.lastname: Bertsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Hielscher
authors.forename: Bronno
authors.initials: B
authors.lastname: van der Holt
authors.forename: Hans
authors.initials: H
authors.lastname: Salwender
authors.forename: Igor W
authors.initials: IW
authors.lastname: Blau
authors.forename: Katja
authors.initials: K
authors.lastname: Weisel
authors.forename: Michael
authors.initials: M
authors.lastname: Pfreundschuh
authors.forename: Christof
authors.initials: C
authors.lastname: Scheid
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dührsen
authors.forename: Walter
authors.initials: W
authors.lastname: Lindemann
authors.forename: Ingo G H
authors.initials: IG
authors.lastname: Schmidt-Wolf
authors.forename: Norma
authors.initials: N
authors.lastname: Peter
authors.forename: Christian
authors.initials: C
authors.lastname: Teschendorf
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
authors.forename: Mathias
authors.initials: M
authors.lastname: Haenel
authors.forename: Hans G
authors.initials: HG
authors.lastname: Derigs
authors.forename: Marc S
authors.initials: MS
authors.lastname: Raab
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Ho
authors.forename: Helgi
authors.initials: H
authors.lastname: van de Velde
authors.forename: Dirk
authors.initials: D
authors.lastname: Hose
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D002886:Chromosomes, Human, Pair 17 / Q000235:genetics; D015331:Cohort Studies; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000628:therapy; D011379:Prognosis; D011719:Pyrazines / Q000627:therapeutic use*; D058496:Smith-Magenis Syndrome; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib