Bortezomib Plus Dexamethasone Induction Improves Outcome of Patients With t(4;14) Myeloma but Not Outcome of Patients With del(17p)

作者：Avet Loiseau Herve^*; Leleu Xavier; Roussel Murielle; Moreau Philippe; Guerin Charbonnel Catherine; Caillot Denis; Marit Gerald; Benboubker Lotfi; Voillat Laurent; Mathiot Claire; Kolb Brigitte; Macro Margaret; Campion Loic; Wetterwald Marc; Stoppa Anne Marie; Hulin Cyrille; Facon Thierry; Attal Michel; Minvielle Stephane; Harousseau Jean Luc

来源：Journal of Clinical Oncology, 2010, 28(30): 4630-4634.

DOI：10.1200/JCO.2010.28.3945

Purpose
Cytogenetics is an important prognostic parameter in multiple myeloma (MM). Patients presenting with either t(4;14) or del(17p) are known to have a short event-free survival (EFS) and overall survival (OS). Some preliminary data suggest that bortezomib is able to overcome these prognostic parameters.
Patients and Methods
A series of 507 patients with newly diagnosed MM who received four cycles of bortezomib-dexamethasone induction therapy before high-dose melphalan were analyzed for both t(4;14) and del(17p).
Results
We found that both t(4;14) and del(17p) remain prognostic parameters, even in the context of bortezomib treatment. However, it is important to note that bortezomib significantly improves the prognosis (in terms of both EFS and OS) of patients with t(4;14), compared with patients treated with vincristine, doxorubicin, and dexamethasone induction therapy. In contrast, no improvement was observed for del(17p) patients.
Conclusion
Short-term bortezomib induction improves outcome of patients with t(4;14) but not the outcome of patients with del(17p). However, both abnormalities remain prognostic factors predicting both EFS and OS despite bortezomib induction.

• 出版日期2010-10