title: [Analysis of prognostic factors in transplant-eligeble newly diagnosed myeloma patients treated with bortezomib plus dexamethasone as induction therapy].
abstract: We retrospectively analyzed, and herein discuss, the outcomes of and prognostic factors for 35 untreated multiple myeloma patients less than 65 years of age who received induction therapies with bortezomib (Bor) and dexamethasone (BD) for the purpose of up-front autologous peripheral blood stem cell transplantation (SCT). The overall response rate was 77% (27 cases, including 4 [11%] complete response and 13 [37%] very good partial response cases). The rate of SCT accomplishment was 51% (18 cases). The 3 year-progression free survival (PFS) rate for the SCT group was significantly higher than that of the non-SCT group (41% vs 0%, P=0.0037). This result reflects the significantly more severe adverse effects of induction therapy for the non-SCT than the SCT group. Among reasons for SCT drop-out, 29% of cases suffered severe peripheral neuropathy with features such as irreversible numbness and pain. The analysis of PFS revealed a cytogenetic factor, favorable chromosomal type at diagnosis, to predict a better outcome (P values on univariate and multivariate analyses were 0.0004 and 0.0405, respectively). Our observations suggest establishment of induction therapy, aimed at reducing adverse effects and overcoming unfavorable cytogenetic abnormalities, to be necessary for improving the outcomes of patients with multiple myeloma.
authors.affiliation: Department of Hematology, Yokohama City University, Medical Center.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Koharazawa
authors.forename: Reina
authors.initials: R
authors.lastname: Watanabe
authors.forename: Yukako
authors.initials: Y
authors.lastname: Hattori
authors.forename: Ayumi
authors.initials: A
authors.lastname: Numata
authors.forename: Rika
authors.initials: R
authors.lastname: Kawasaki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kuwabara
authors.forename: Maki
authors.initials: M
authors.lastname: Hagihara
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.forename: Chizuko
authors.initials: C
authors.lastname: Hashimoto
authors.forename: Sachiya
authors.initials: S
authors.lastname: Takemura
authors.forename: Etsuko
authors.initials: E
authors.lastname: Yamazaki
authors.forename: Katsumichi
authors.initials: K
authors.lastname: Fujimaki
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Tomita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujita
authors.forename: Rika
authors.initials: R
authors.lastname: Sakai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Harano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
authors.forename: Shin
authors.initials: S
authors.lastname: Fujisawa
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D020360:Neoadjuvant Therapy / Q000379:methods; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D011719:Pyrazines / Q000008:administration & dosage; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone