Bortezomib, liposomal doxorubicin and dexamethasone followed by thalidomide and dexamethasone is an effective treatment for patients with newly diagnosed multiple myeloma with Internatinal Staging System stage II or III, or extramedullary disease Journal Article


Authors: Landau, H.; Pandit-Taskar, N.; Hassoun, H.; Cohen, A.; Lesokhin, A.; Lendvai, N.; Drullinsky, P.; Schulman, P.; Jhanwar, S.; Hoover, E.; Bello, C.; Riedel, E.; Nimer, S. D.; Comenzo, R. L.
Article Title: Bortezomib, liposomal doxorubicin and dexamethasone followed by thalidomide and dexamethasone is an effective treatment for patients with newly diagnosed multiple myeloma with Internatinal Staging System stage II or III, or extramedullary disease
Abstract: We evaluated sequential bortezomib, liposomal doxorubicin and dexamethasone (BDD) followed by thalidomide and dexamethasone (TD) if ≥ partial response (PR) or bortezomib and TD (BTD) if < PR in untreated patients with multiple myeloma with International Staging System stage II/III or extramedullary disease. Of the 42 patients enrolled, two-thirds had cytogenetic abnormalities including high-risk findings [del(13q) by karyotype, t(4;14), loss of p53 or gain 1q] in one-third. After the planned three cycles of BDD, the overall response rate (ORR) was 81% with 40% ≥ very good partial response (VGPR), including 26% near complete and complete responses (nCR/CR). After the additional two cycles of TD or BTD, ORR was 83% with 60% ≥ VGPR including 43% nCR/CR, indicating deeper responses following sequential therapy (p = 0.008). Two-thirds of patients who presented with significant renal impairment had improved renal function. All patients undergoing stem cell harvest had a successful collection. BDD followed by TD or BTD is effective initial therapy for this population with higher-risk myeloma and results in rapid disease control and a high response rate. © 2012 Informa UK, Ltd.
Keywords: adult; clinical article; treatment response; aged; aged, 80 and over; middle aged; survival rate; overall survival; thalidomide; constipation; fatigue; neutropenia; doxorubicin; cancer growth; diarrhea; dose response; side effect; cancer staging; follow-up studies; neoplasm staging; bortezomib; drug eruption; infection; multiple cycle treatment; multiple myeloma; sensory neuropathy; boronic acids; pyrazines; anemia; nausea; thrombocytopenia; vomiting; antineoplastic combined chemotherapy protocols; dexamethasone; deep vein thrombosis; stem cell transplantation; protein p53; high risk patient; abdominal pain; hyperglycemia; lung embolism; drug fatality; kidney function; stem cell mobilization; muscle weakness; hyperbilirubinemia; hand foot syndrome; karyotype; loss of function mutation; neuropathic pain; heart atrium fibrillation; renal failure; mood disorder; fluid retention; septicemia; kidney dysfunction; extramedullary hematopoiesis; sequential therapy; chromosome deletion 13; extramedullary; gain of function mutation; sarcoma, myeloid; international staging system
Journal Title: Leukemia and Lymphoma
Volume: 53
Issue: 2
ISSN: 1042-8194
Publisher: Taylor & Francis Group  
Date Published: 2012-02-01
Start Page: 275
End Page: 281
Language: English
DOI: 10.3109/10428194.2011.606943
PROVIDER: scopus
PUBMED: 21824051
DOI/URL:
Notes: --- - "Export Date: 1 March 2012" - "CODEN: LELYE" - "Source: Scopus"
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MSK Authors
  1. Hani Hassoun
    149 Hassoun
  2. Stephen D Nimer
    345 Nimer
  3. Heather Jolie Landau
    189 Landau
  4. Nikoletta Lendvai
    87 Lendvai
  5. Suresh C Jhanwar
    217 Jhanwar
  6. Alexander Meyer Lesokhin
    118 Lesokhin
  7. Christina Bello
    15 Bello
  8. Elizabeth Hoover
    19 Hoover