title: Bendamustine and prednisone in combination with bortezomib (BPV) in the treatment of patients with relapsed or refractory multiple myeloma and light chain-induced renal failure.
abstract: BACKGROUND
  Serious renal failure represents a severe complication of multiple myeloma (MM), with an estimated 25-50 % of patients being affected. Both bortezomib and bendamustine have been identified as quickly acting, effective and well-tolerated drugs and might therefore constitute an adequate combination regimen for patients presenting with light chain-induced renal failure.
  
  
  METHODS
  Between March 2005 and March 2013, 36 patients with relapsed/refractory MM and light chain-induced renal failure (creatinine clearance <60 ml/min) were treated with bendamustine 60 mg/m(2) on days 1 and 2, bortezomib 1.3 mg/m(2) on days 1, 4, 8 and 11 and prednisone 100 mg on days 1, 2, 4, 8 and 11 (BPV). Patients were divided according to severity of renal impairment into group A (n = 20) with moderate or severe renal dysfunction (eGFR 15-59 ml/min) and group B (n = 16) with renal failure/dialysis (eGFR <15 ml/min).
  
  
  RESULTS
  Twenty-four patients (67 %) responded with three CR, three nCR, six VGPR and 12 PR. Six patients had minor response, two stable and four progressive disease. With a median follow-up period of 22 months, median progression-free survival (PFS) and overall survival (OS) for patients of group A were 10 and 25 months, respectively. This outcome was significantly better compared to patients of group B with a median PFS and OS of 3 and 7 months, respectively. Eleven patients showed a CRrenal, five a PRrenal and 15 a MRrenal. These results indicate that this BPV combination is feasible, effective and well tolerated in patients with relapsed/refractory MM and light chain-induced renal failure.
authors.affiliation: Department of Hematology, Oncology and Hemostaseology, University Clinical Center, University of Leipzig, Leipzig, Germany, Wolfram.Poenisch@medizin.uni-leipzig.de.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Pönisch
authors.forename: Barbara
authors.initials: B
authors.lastname: Moll
authors.forename: Malvina
authors.initials: M
authors.lastname: Bourgeois
authors.forename: Marc
authors.initials: M
authors.lastname: Andrea
authors.forename: Thomas
authors.initials: T
authors.lastname: Schliwa
authors.forename: Simone
authors.initials: S
authors.lastname: Heyn
authors.forename: Marion
authors.initials: M
authors.lastname: Schmalfeld
authors.forename: Thomas
authors.initials: T
authors.lastname: Edelmann
authors.forename: Cornelia
authors.initials: C
authors.lastname: Becker
authors.forename: Franz Albert
authors.initials: FA
authors.lastname: Hoffmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarzer
authors.forename: Ute
authors.initials: U
authors.lastname: Kreibich
authors.forename: Matthias
authors.initials: M
authors.lastname: Egert
authors.forename: Runa
authors.initials: R
authors.lastname: Stiegler
authors.forename: Rainer
authors.initials: R
authors.lastname: Krahl
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Remane
authors.forename: Anette
authors.initials: A
authors.lastname: Bachmann
authors.forename: Tom
authors.initials: T
authors.lastname: Lindner
authors.forename: Lorenz
authors.initials: L
authors.lastname: Weidhase
authors.forename: Sirak
authors.initials: S
authors.lastname: Petros
authors.forename: Stefan
authors.initials: S
authors.lastname: Fricke
authors.forename: Vladan
authors.initials: V
authors.lastname: Vucinic
authors.forename: Haifa
authors.initials: H
authors.lastname: Al Ali
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; 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; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology*; D009367:Neoplasm Staging; 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 / Q000276:immunology / Q000503:physiopathology*; D012189:Retrospective Studies
chemical_list: D001897:Boronic Acids; D007147:Immunoglobulin Light Chains; D009588:Nitrogen Mustard Compounds; D011719:Pyrazines; D000069286:Bortezomib; D000069461:Bendamustine Hydrochloride; D011241:Prednisone
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