title: Changes in osteoblastic activity in patient who received bortezomib as second line treatment for plasma cell myeloma: a prospective multicenter study.
abstract: We conducted a prospective multicenter study identifying the role of bortezomib in patients with relapsed or refractory plasma cell myeloma (PCM) in bone resorption and formation via bone turnover markers. A total of 104 patients received at least 1 cycle of bortezomib. Most of them had advanced disease (n = 89). Among them, 75 patients completed 4 cycles of treatment. Most of the patients (81.7%) were treated in combination with steroid. After the 4th cycle treatment, 47 of 75 patients achieved CR, nCR, VGPR, and PR (64.4%), while 26 patients achieved less than PR (35.6%). The proportion of patients who achieved ≥ PR increased as patients received more treatment cycles, reaching 90% after the 8th cycle. DKK-1 levels decreased significantly posttreatment. Bone formation markers (bALP and OC) and osteoclast regulator such as sRANKL also decreased significantly. These findings were observed primarily in patients who received steroid and who had a longer disease duration. While sRANKL demonstrated significant reduction posttreatment, osteoprotegerin (OPG) level did not significantly change posttreatment, resulting in a decreased sRANKL/OPG ratio (P = 0.037). In conclusion, our clinical data suggest that treatment with bortezomib and steroid may rearrange the metabolic balance between osteoblast and osteoclast activities in PCM.
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
authors: Ki-Seong
authors: KS
authors: Eom
authors: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
authors: Seok Jin
authors: SJ
authors: Kim
authors: Department of Hematology-Oncology, Chonnam National University Medical School, Jeollanam-do 519-763, Republic of Korea.
authors: Je-Jung
authors: JJ
authors: Lee
authors: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea.
authors: Cheolwon
authors: C
authors: Suh
authors: Department of Internal Medicine, Yonsei University College of Medicine 120-752, Republic of Korea.
authors: Jin Seok
authors: JS
authors: Kim
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul 110-744, Republic of Korea.
authors: Sung-Soo
authors: SS
authors: Yoon
authors: Department of Medicine, Korea University Medical Center, Seoul 136-705, Republic of Korea.
authors: Byung Soo
authors: BS
authors: Kim
authors: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul 139-706, Republic of Korea.
authors: Hye Jin
authors: HJ
authors: Kang
authors: Department of Internal Medicine, Pusan National University School of Medicine, Busan 602-739, Republic of Korea.
authors: Young Jin
authors: YJ
authors: Choi
authors: Inha University Hospital, Incheon 400-711, Republic of Korea.
authors: Chul Soo
authors: CS
authors: Kim
authors: Departments of Hematology/Oncology and Internal Medicine, Kosin University Gospel Hospital, Busan 602-702, Republic of Korea.
authors: Yang Soo
authors: YS
authors: Kim
authors: Department of Internal Medicine, Chonbuk National University Hospital, Jeonju 561-712, Republic of Korea.
authors: Jae-Yong
authors: JY
authors: Kwak
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
authors: Yoo Jin
authors: YJ
authors: Kim
authors: Department of Internal Medicine, Inje University College of Medicine, Busan 612-896, Republic of Korea.
authors: Young Don
authors: YD
authors: Joo
authors: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul 158-710, Republic of Korea.
authors: Yeung-Chul
authors: YC
authors: Mun
authors: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon 310-721, Republic of Korea.
authors: Deog Yeon
authors: DY
authors: Jo
authors: Department of Hematology-Oncology, Ajou University Hospital, Suwon 443-380, Republic of Korea.
authors: Joon Seong
authors: JS
authors: Park
authors: Department of Internal Medicine, Chosun University College of Medicine, Gwangju 501-717, Republic of Korea.
authors: Chi-Young
authors: CY
authors: Park
authors: Department of Internal Medicine, Dong-A University College of Medicine, Busan 602-715, Republic of Korea.
authors: Sung-Hyun
authors: SH
authors: Kim
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Republic of Korea.
authors: Chang-Ki
authors: CK
authors: Min
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001842:Bone and Bones / Q000187:drug effects / Q000473:pathology; D001897:Boronic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D000069286:Bortezomib; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D010006:Osteoblasts / Q000187:drug effects / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000188:drug therapy; D011446:Prospective Studies; D011719:Pyrazines / Q000494:pharmacology / Q000627:therapeutic use*; D013256:Steroids / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001897:Boronic Acids; D011719:Pyrazines; D013256:Steroids; D000069286:Bortezomib