Major tumor shrinking and
persistent molecular remissions after consolidation with bortezomib,
thalidomide, and dexamethasone in patients with autografted myeloma.
J Clin Oncol. 2010 Apr 20;28(12):2077-84.
Ladetto M, Pagliano G, Ferrero S, Cavallo F, Drandi D, Santo L, Crippa C, De Rosa L, Pregno P, Grasso M, Liberati AM, Caravita T, Pisani F, Guglielmelli T, Callea V, Musto P, Cangialosi C, Passera R, Boccadoro M, Palumbo A.
39 myeloma patients treated with autologous stem cell transplantation and in a status of minimal residual disease (= achievement of at least a very good partial response and positive for IgH rearrangement by PCR) received post-transplant consolidation with 4 monthly cycles of VTD:
- Bortezomib 1.6 mg/m2 IV days 1, 8, 15, 22
- Thalidomide 200 mg PO qhs
- Dexamethasone 20 mg PO on days 1-4, 8-11, 15-18
- CR with negative immunofixation increased from 15% after transplant to 49% after consolidation therapy with VTD
- Molecular remissions by PCR increased from 3% after transplant to 18% after consolidation with VTD
- After a median follow-up of 42 months, no patient in molecular CR relapsed
Review of phenotypic
markers used in flow cytometric analysis of MGUS and MM, and applicability of
flow cytometry in other plasma cell disorders.
Br J Haematol. 2010 May;149(3):334-51.
Raja KR, Kovarova L, Hajek R.
cell leukemia and autologous stem cell transplantation.
Haematologica. 2010 May;95(5):804-9.
Drake MB, Iacobelli S, van Biezen A, Morris C, Apperley JF, Niederwieser D, Björkstrand B, Gahrton G; European Group for Blood and Marrow Transplantation and the European Leukemia Net.
This is a retrospective analysis of 272 patients with primary plasma cell leukemia treated with autologous stem cell transplantation between 1980 and 2006. Median overall survival was 25.7 months, inferior to that of 20,844 myeloma patients (62.3 months).
Clinical efficacy of a bortezomib, cyclophosphamide,
thalidomide, and dexamethasone (Vel-CTD) regimen in patients with relapsed or
refractory multiple myeloma: a phase II study.
Ann Hematol. 2010 May;89(5):475-82.
Kim YK, Sohn SK, Lee JH, Yang DH, Moon JH, Ahn JS, Kim HJ, Lee JJ; Korean Multiple Myeloma Working Party (KMMWP).
70 patients with relapsed/refractory myeloma were treated with bortezomib + CTD:
- Bortezomib 1.3 mg/m2 IV days 1, 4, 8, 11
- Cyclophosphamide 150 mg/m2 PO days 1-4
- Thalidomide 50 mg PO qd
- Dexamethasone 20 mg IV days 1, 4, 8, 11
- Response rate: 88%
- CR: 46%
- Median progression-free survival: 14.6 months
- Median overall survival 31.6 months
- Grade 3-4 neutropenia was 4%, and grade 3-4 thrombocytopenia was 12%
radiotherapy and the risk of secondary leukemia and multiple myeloma.
Cancer. 2010 May 15;116(10):2486-92.
Wright JD, St Clair CM, Deutsch I, Burke WM, Gorrochurn P, Sun X, Herzog TJ.
This study analyzed the risk of leukemia and myeloma among 66,896 patients who received pelvic radiotherapy, compared with 132,372 individuals not treated with radiation. The authors found that pelvic radiation was associated with an increased risk of secondary leukemia, but not an increase the risk of multiple myeloma.
The t(14;20)(q32;q12): a rare cytogenetic change in
multiple myeloma associated with poor outcome.
Br J Haematol. 2010 Jun;149(6):901-4.
Vekemans MC, Lemmens H, Delforge M, Doyen C, Pierre P, Demuynck H, Bries G, Lemmens J, Meeus P, Straetmans N, Bauwens D, Vidrequin S, Rack K, Vandenberghe P, Wlodarska I, Michaux L.
In this study, median overall survival of 15 patients with the t(14;20) translocation was only 19 months.
Giampaolo Talamo, MD