Abstract
Patients with multiple myeloma and dialysis-dependent renal failure have dismal outcomes. In this retrospective analysis of a case series, we evaluated 27 consecutive patients, all of whom required haemodialysis at the time of first-line induction therapy with either bortezomib or a standard regimen followed by high-dose chemotherapy and auto-SCT. The overall response rate was significantly better after bortezomib-based induction before auto-SCT (83% vs 36%, P=0.02) and at day +100 post auto-SCT (100% vs 58%, P=0.01). Bortezomib also prolonged EFS and furthermore, a trend towards a shorter time on haemodialysis was observed in the bortezomib group at a median of 6.1 months (0.2–68.2 months) vs 17.1 months (0.7–94.3 months, P=0.38) in patients who had received vincristine, adriamycin, dexamethasone or vincristine, adriamycin, dexamethasone-like induction regimens. These data demonstrate the superior efficacy of bortezomib-based induction therapy in transplant-eligible patients with end-stage renal failure.
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We thank the Dietmar-Hopp Foundation and the German Cancer Aid for financial support. This work was also supported by the medical faculty of science of the University of Heidelberg, Germany.
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Breitkreutz, I., Heiss, C., Perne, A. et al. Bortezomib improves outcome after SCT in multiple myeloma patients with end-stage renal failure. Bone Marrow Transplant 49, 1371–1375 (2014). https://doi.org/10.1038/bmt.2014.165
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DOI: https://doi.org/10.1038/bmt.2014.165
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