title: Successful treatment of patients with newly diagnosed/untreated multiple myeloma and advanced renal failure using bortezomib in combination with bendamustine and prednisone.
abstract: OBJECTIVE
  Renal failure is a frequent complication of multiple myeloma (MM) and, if present at diagnosis, a considerable risk factor for outcome. Treatment with chemotherapy and/or new agents may result in recovery of renal function in up to 50 % of patients. The window of opportunity to reverse renal impairment is, however, rather small, making an immediate and highly active treatment strategy mandatory. Bortezomib as well as bendamustine has been demonstrated to be potent drugs in the treatment of MM.
  
  
  METHODS
  A total of 18 patients with newly diagnosed/untreated MM and renal insufficiency (GFR < 35 ml/min) were treated with bendamustine, prednisone, and bortezomib (BPV).
  
  
  RESULTS
  The majority of them (n = 15; 83 %) responded after at least one cycle of chemotherapy with three sCR, five nCR, five VGPR, and two PR. With a median follow-up of 17 months, PFS at 18 months was 57 % and OS was 61 %. The myeloma protein decreased rapidly, reaching the best response after the first cycle in four and after the second cycle in additional seven patients. Thirteen patients (72 %) improved their renal function after treatment.
  
  
  CONCLUSIONS
  We conclude that the combination of bortezomib, bendamustine, and prednisone is effective and well tolerated in patients with a newly diagnosed MM and renal failure.
authors.affiliation: University of Leipzig, Leipzig, Germany. Wolfram.Poenisch@medizin.uni-leipzig.de
authors.forename: Wolfram
authors.initials: W
authors.lastname: Pönisch
authors.forename: Marc
authors.initials: M
authors.lastname: Andrea
authors.forename: Ina
authors.initials: I
authors.lastname: Wagner
authors.forename: Doreen
authors.initials: D
authors.lastname: Hammerschmidt
authors.forename: Ute
authors.initials: U
authors.lastname: Kreibich
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarzer
authors.forename: Thomas
authors.initials: T
authors.lastname: Zehrfeld
authors.forename: Maik
authors.initials: M
authors.lastname: Schwarz
authors.forename: Cornelia
authors.initials: C
authors.lastname: Winkelmann
authors.forename: Sirak
authors.initials: S
authors.lastname: Petros
authors.forename: Anette
authors.initials: A
authors.lastname: Bachmann
authors.forename: Tom
authors.initials: T
authors.lastname: Lindner
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects; D000069286:Bortezomib; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D009325:Nausea / Q000139:chemically induced; D009588:Nitrogen Mustard Compounds / Q000008:administration & dosage / Q000009:adverse effects; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects; D051437:Renal Insufficiency / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
chemical_list: D001897:Boronic Acids; D009588:Nitrogen Mustard Compounds; D011719:Pyrazines; D000069286:Bortezomib; D000069461:Bendamustine Hydrochloride; D011241:Prednisone