Therapeutic effects of high-dose dexamethasone combined with thalidomide and bortezomib on renal function in patients newly diagnosed multiple myeloma
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GAO Da(Department of Hematology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China)
XIAO Zhen(Department of Hematology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China)
- Journal Title:
Journal of Leukemia & Lymphoma
Volume 21, Issue 10, 2012
- Key Word:
Multiple myeloma;Renal insufficiency;Dexamethasone;Thalidomide;Bortezomib
Objective To assess the efficacy of high dose dexamethasone combined with bortezomib and thalidomide in multiple myeloma (MM) patients with acute renal failure.Methods 23 newly diagoosed MM patients with acute renal failure were treated with high dose dexamethasone combined with bortezomib and thalidomide.Results Reversal of renal failure was documented in 58.3 ％ (7/12) of those severe renal failure patients and 81.8 ％ (9/11) of renal failure patients.Renal function was reversed in 69.5 ％ (16/23) of all patients.The total response rate for MM was 60.9 ％ (14/23).The median time to response was 2 (1-5) months. Overall survival (OS) at 3 years was 56.5 ％ and the median survival time was 34.4 months.Conclusion Renal failure was reversible in the majority of newly diagnosed MM patients treated with highdose dexamethasone containing regimens.The addition of novel agents thalidomide and (or) bortezomib is safe and induces a more rapid renal failure reversal compared with routine chemotherapy.
- Raab MS,Podar K,Breitkreutz I,et al.Multiple myeloma.Lancet,2009,374:324-339.
- Kyle RA,Gertz MA,Witzig TE,et al.Review of 1027 patients with newly diagnosed multiple myeloma.Mayo Clin Proc,2003,78:21-33.
- Heher EC,Goes NB,Spitzer TR,et al.Kidney disease associated with plasma cell dyscrasias.Blood,2010,116:1397-1404.
- Ludwig H,Beksac M, Blade J, et al. Multiple myeloma treatment strategies with novel agents in 2011: a European perspective.Oncologist,2011,16:388-403.
- Morabito F, Gentile M, Ciolli S, et al. Safety and efficacy of bortezomib-based regimens for multiple myeloma patients with renal impairment: a retrospective study of Italian Myeloma Network GIMEMA.Eur J Haematol,2010,84:223-228.
- Svnold TW,Takimoto CH,Doroshow JH,et al.Dose-escalating and pharmacologic study of oxaliplatin in adult cancer patients with impaired hepatic function: a National Cancer Institute Organ Dysfunction Working Group study.Clin Cancer Res,2007,13:3660-3666.
- Moumas E,Hanf W,Desport E,et al.New insights in the treatment of mveloma with renal faihure.Nephrol Ther,2011,7:457-466.
- Adams J. Proteasome inhibition in cancer: development of PS-341.Semi n Oncol,2001,28:613-619.
- Eda H,Aoki K,Kato S,et al.The proteasome inhibitor bortezomib inhibits FGF-2-induced reduction of TAZ levels in osteoblast-like cells.Eur J Haematol,2010,85:68-75.
- Hideshima T, Ikeda H, Chauhan D, et al. Bortezomib induces canonical nuclear factor-kappaB activation in multiple myeloma cells.Blood,2009,114:1046-1052.
- Roussou M,Kastritis E,Christoulas D,et al.Reversibility of renal failure in newly diagnosed patients with multiple myeloma and the role of novel agents.Leuk Res,2010,34:1395-1397.
- Dimopoulos MA,Richardson PG,Schlag R,et al.VMP (Bortezomib,Melphalan, and Prednisone) is active and well tolerated in newly diagnosed patients with multiple myeloma with moderately impaired renal function. and results in reversal of renal impairment: eohortanalysis of the phase Ⅲ VISTA study.J Clin Oncol,2009,27:6086-6093.
- Ludwig H,Adam Z,Hajek R,et al.Light chain-induced acute renal failure can be reversed by bortezomib-doxorubicin-dexamethasone in multiple myeloma:results of a phase Ⅱ study.J Clin Oncol,2010,28:4635-4641.