title: Rapid progression of anemia related to tumor-lysis syndrome associated with bortezomib treatment in myeloma patients.
abstract: OBJECTIVE
  Tumor-lysis syndrome is a rare complication in patients with multiple myeloma. However, bortezomib treatment for myeloma is often associated with tumor-lysis syndrome.
  
  
  METHODS
  We developed an index called the rapid anemia progression index, which represents the duration and progression of anemia, to evaluate risk factors for tumor-lysis syndrome. We retrospectively reviewed 35 relapsed or refractory myeloma patients treated with bortezomib-containing treatment in our institution. We analyzed various parameters, including albumin, lactase dehydrogenase, β2-microglobulin and creatinine, similar to the rapid anemia progression index, and evaluated the risk factors for tumor-lysis syndrome associated with bortezomib by the Cairo-Bishop definition.
  
  
  RESULTS
  Clinical tumor-lysis syndrome occurred in six patients (17.1%). Tumor-lysis syndrome occurred during the first course of bortezomib-containing treatment among all the patients. The result of the area under the receiver operating characteristic curve for the rapid anemia progression index was 0.759 (P = 0.049). The rapid anemia progression index was more accurate than the index of lactate dehydrogenase, β2-microglobulin, albumin and creatinine according to the receiver operating characteristic curve. For a cut-off point of -1.12 for the rapid anemia progression index, the sensitivity and specificity were 66.7 and 82.8%, respectively.
  
  
  CONCLUSIONS
  The rapid anemia progression index is related to clinical tumor-lysis syndrome associated with bortezomib treatment for multiple myeloma patients with a cut-off point of -1.12 g/dl/month.
authors.affiliation: * Department of Medical Hematology/Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. khatake@jfcr.or.jp.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Terui
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishimura
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ueda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mishima
authors.forename: Sakura
authors.initials: S
authors.lastname: Sakajiri
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aiba
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Hatake
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D000069286:Bortezomib; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011237:Predictive Value of Tests; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D015275:Tumor Lysis Syndrome / Q000150:complications* / Q000209:etiology*; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D001897:Boronic Acids; D011719:Pyrazines; D012709:Serum Albumin; D001613:beta 2-Microglobulin; D000069286:Bortezomib; D003404:Creatinine; D007770:L-Lactate Dehydrogenase
keywords: hematol-leukemia/lymphoma; prognostic factors; supportive care