Ocena učinkovitosti prvega zdravljenja z bortezomibom pred avtologno presaditvijo krvotvornih matičnih celic pri diseminiranem plazmocitomu
Effectiveness of first treatment with bortezomib prior to autologous stem cell transplantation for multiple myeloma

slovenian

2012

volume 81, issue 4

Antibodies, Monoclonal   Bence Jones Protein   Dexamethasone   Drug Therapy   Hematopoietic Stem Cell Transplantation   Kidney Failure   Multiple Myeloma   Proteinuria   Retrospective Studies   Therapy   Treatment Outcome

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background: In this retrospective study we evaluated effectiveness and safety of first- line treatment with bortezomib and dexamethasone in multiple myelomapatients, comparing our results with already published clinical studies. Methods: Patients received bortezomib as part of everyday clinical practice and according to the latest guidelines of the Združenje hematologov Slovenije . Patients who were previously treated with first-line VAD (vincristine, doxorubicin modified with farmarubicine, dexamethasone), but dueto uneffectiveness changed the treatment to bortezomib, were also included in the study. In 30 patients effectivenes was evaluated after average 3-4 cycles of bortezomib and dexamethasone according to the modified Southwest Oncology Group criteria. Treatment effectiveness was evaluated according to the previous VAD treatment, renal function and cytogenetic analysis. Side effects and reasons for early treatment discontinuation were described. Results: Patients received 2 to 8 cycles (median 4 cycles) of bortezomib and dexamethasone treatment. After average 3-4 cycles, 80% of patients acheived good treatment response (56.7% very good partial response, 23.3% partial response). We observed that the treatment, renal insufficiency and negative cytogenetic analysis, sionce we observed similar rates of very good partial response ande partial response in patients without previous VAD treatment (82.3% vs. 76.9%), normal renal function (85.7% vs. 75%) and normal cytogenetics (77.8% vs. 80%), although statistical evaluation was not possibledue to small number of patients. The most common side effect was neuropathy (40%) and in 5 patients (16.6%), due to grade 3 or more, the treatment was discontinued. Other side effects were: anemia (26%), infection (166%), thrombocytopenia (10%), neutropenia (6.6%), gastrointestinal problems (23.3%) and herpes zooster (6.6%). (Abstract truncated at 2000 characters).

14.08.2013