Bortezomib after dose-reduced allogeneic stem cell transplantation for multiple myeloma to enhance or maintain remission status
Bortezomib after dose-reduced allogeneic stem cell transplantation for multiple myeloma to enhance or maintain remission status
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DOI：
10.1016/j.exphem.2006.02.020
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发表时间：
2006-06-01
影响因子：
2.6
通讯作者：
Zander, Axel
中科院分区：
文献类型：
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作者：
Kroeger, Nicolaus;Zabelina, TatJana;Zander, Axel
Objective.我们研究了多发性骨髓瘤患者在减少剂量的异基因干细胞移植（SCT）后，静脉注射硼替佐米（1.3 mg/m2，第1、4、8和11天）至少2个周期对毒性、CD 3（+）细胞、移植物抗宿主病（GvHD）和反应的影响。纳入了18例无疾病进展的多发性骨髓瘤患者。在同种异体移植术后中位8个月给予蛋白酶体抑制剂以增强或维持缓解状态。14例患者（78%）完成了拟定的2个周期。4例患者因神经毒性（n = 3）或胃肠道毒性（n = 1）而不得不停止治疗。重度III/IV级毒性见于血小板减少症（50%）、白细胞减少症（17%）或神经病变（17%），这在与环孢霉素合并治疗的患者中更常见（P = 0.06）。治疗期间中位循环CD 3（+）细胞从550 μ L降至438 μ L（p = 0.03），导致3例患者（17%）发生带状疱疹感染。在3名患者中，注意到现有的皮肤急性或慢性GvHD轻度加重，在1名患者中，注意到新发皮肤I级急性GvHD。在可测量疾病的患者中，分别有3例（30%）、5例（50%）和2例（20%）患者出现完全缓解、部分缓解和轻微反应。结论。同种异体SCT后硼替佐米是有效的，但需要进一步的研究来平衡疗效与潜在的危险，如感染并发症，GvHD加重和神经毒性。(c)2006年国际实验血液学学会。出版社：Elsevier Inc.
Objective. We investigated the effect of at least two cycles of bortezomib (1.3 mg/m(2) intravenously, days 1, 4, 8, and 11) after dose-reduced allogeneic stem cell transplantation (SCT) on toxicity, CD3(+) cells, graft-versus-host disease (GvHD), and response in patients with multiple myeloma.Methods. Eighteen patients with multiple myeloma without progressive disease were included. The proteasome inhibitor was given at median of 8 months after allografting to enhance or maintain remission status.Results. Fourteen patients (78%) completed the proposed two cycles. Four patients had to discontinue therapy due to neurotoxicity (n = 3) or gastrointestinal toxicity (n = 1). Severe grade III/IV toxicity was seen for thrombocytopenia (50%), leukopenia (17%), or neuropathy (17%), which was more often seen in patients treated concomitantly with cyclosporine (P = 0.06). The median circulating CD3(+) cells decreased during treatment from 550 mu L to 438 mu L (p = 0.03), resulting in herpes zoster infection in three patients (17%). In three patients, a mild aggravation of existing acute or chronic GvHD of the skin, and in one patient de novo skin grade I acute GvHD was noted. In patients with measurable disease, complete remission, partial remission, and minor response was seen in 3 (30%), 5 (50%), and 2 (20%) patients, respective.Conclusion. Bortezomib after allogeneic SCT is effective but further studies are needed to balance the efficacy with potential hazards such as infectious complications, aggravation of GvHD, and neurotoxicity. (c) 2006 International Society for Experimental Hematology. Publishedby Elsevier Inc.