Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma

Alessandro Corso, Luciana Barbarano, Silvia Mangiacavalli, Mauro Spriano, Emilio P. Alessandrino, Anna Maria Cafro, Cristiana Pascutto, Marzia Varettoni, Paolo Bernasconi, Giovanni Grillo, Angelo M. Carella, Luigi Montalbetti, Mario Lazzarino, Enrica Morra

Research output: Contribution to journalArticle

Abstract

The aim of this phase II trial was to investigate the efficacy of bortezomib plus dexamethasone (Vel-Dex) as induction therapy in patients with multiple myeloma (MM) and to define the role of intensification before transplantation. Fifty-seven patients were treated with four courses of Vel-Dex, two cycles of dexamethasone, cyclophosphamide, etoposide and cisplatin (DCEP), and a single autologous transplant. Fourteen patients (25) went off-study: seven after Vel-Dex, seven after DCEP. All patients yielded high numbers of stem cells (median CD34 cells 7.5×106/kg); 54 of the 57 patients (94) collected ≥4×106/kg CD34 cells, 60 with a single leukapheresis. The overall response rate (ORR) after Vel-Dex was 86 (70 had a very good partial response [VGPR] or better) regardless of cytogenetic abnormalities and International Staging System stage (ISS). The response at the end of the two DCEP cycles remained unchanged in 35 patients (70), worsened in 15 (20), and improved in 5 (10). Because of the consistent drop-out, the ORR in intention-to-treat analysis decreased significantly from 86 after Vel-Dex to 76 after DCEP, and 73 after transplantation. However, when considering the subset of 43 patients who completed the program, the ORR was 96 (complete response 39, VGPR 41, partial response 16). In conclusion, Vel-Dex produces high response rates, improves stem cell collection, and overcomes the need for intensification before autologous transplantation.

Original languageEnglish
Pages (from-to)236-242
Number of pages7
JournalLeukemia and Lymphoma
Volume51
Issue number2
DOIs
Publication statusPublished - Feb 2010

Fingerprint

Autografts
Dexamethasone
Stem Cells
Drug Therapy
Etoposide
Cyclophosphamide
Cisplatin
Transplantation
Leukapheresis
Intention to Treat Analysis
Autologous Transplantation
Bortezomib
Multiple Myeloma
Chromosome Aberrations

Keywords

  • Bortezomib
  • DCEP
  • High-dose therapy
  • Induction therapy
  • Multiple myeloma
  • Peripheral stem cell collection

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma. / Corso, Alessandro; Barbarano, Luciana; Mangiacavalli, Silvia; Spriano, Mauro; Alessandrino, Emilio P.; Cafro, Anna Maria; Pascutto, Cristiana; Varettoni, Marzia; Bernasconi, Paolo; Grillo, Giovanni; Carella, Angelo M.; Montalbetti, Luigi; Lazzarino, Mario; Morra, Enrica.

In: Leukemia and Lymphoma, Vol. 51, No. 2, 02.2010, p. 236-242.

Research output: Contribution to journalArticle

Corso, Alessandro ; Barbarano, Luciana ; Mangiacavalli, Silvia ; Spriano, Mauro ; Alessandrino, Emilio P. ; Cafro, Anna Maria ; Pascutto, Cristiana ; Varettoni, Marzia ; Bernasconi, Paolo ; Grillo, Giovanni ; Carella, Angelo M. ; Montalbetti, Luigi ; Lazzarino, Mario ; Morra, Enrica. / Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma. In: Leukemia and Lymphoma. 2010 ; Vol. 51, No. 2. pp. 236-242.
@article{beff0fb4ee81477a9fcad707646e0103,
title = "Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma",
abstract = "The aim of this phase II trial was to investigate the efficacy of bortezomib plus dexamethasone (Vel-Dex) as induction therapy in patients with multiple myeloma (MM) and to define the role of intensification before transplantation. Fifty-seven patients were treated with four courses of Vel-Dex, two cycles of dexamethasone, cyclophosphamide, etoposide and cisplatin (DCEP), and a single autologous transplant. Fourteen patients (25) went off-study: seven after Vel-Dex, seven after DCEP. All patients yielded high numbers of stem cells (median CD34 cells 7.5×106/kg); 54 of the 57 patients (94) collected ≥4×106/kg CD34 cells, 60 with a single leukapheresis. The overall response rate (ORR) after Vel-Dex was 86 (70 had a very good partial response [VGPR] or better) regardless of cytogenetic abnormalities and International Staging System stage (ISS). The response at the end of the two DCEP cycles remained unchanged in 35 patients (70), worsened in 15 (20), and improved in 5 (10). Because of the consistent drop-out, the ORR in intention-to-treat analysis decreased significantly from 86 after Vel-Dex to 76 after DCEP, and 73 after transplantation. However, when considering the subset of 43 patients who completed the program, the ORR was 96 (complete response 39, VGPR 41, partial response 16). In conclusion, Vel-Dex produces high response rates, improves stem cell collection, and overcomes the need for intensification before autologous transplantation.",
keywords = "Bortezomib, DCEP, High-dose therapy, Induction therapy, Multiple myeloma, Peripheral stem cell collection",
author = "Alessandro Corso and Luciana Barbarano and Silvia Mangiacavalli and Mauro Spriano and Alessandrino, {Emilio P.} and Cafro, {Anna Maria} and Cristiana Pascutto and Marzia Varettoni and Paolo Bernasconi and Giovanni Grillo and Carella, {Angelo M.} and Luigi Montalbetti and Mario Lazzarino and Enrica Morra",
year = "2010",
month = "2",
doi = "10.3109/10428190903452826",
language = "English",
volume = "51",
pages = "236--242",
journal = "Leukemia and Lymphoma",
issn = "1042-8194",
publisher = "Taylor and Francis Ltd.",
number = "2",

}

TY - JOUR

T1 - Bortezomib plus dexamethasone can improve stem cell collection and overcome the need for additional chemotherapy before autologous transplant in patients with myeloma

AU - Corso, Alessandro

AU - Barbarano, Luciana

AU - Mangiacavalli, Silvia

AU - Spriano, Mauro

AU - Alessandrino, Emilio P.

AU - Cafro, Anna Maria

AU - Pascutto, Cristiana

AU - Varettoni, Marzia

AU - Bernasconi, Paolo

AU - Grillo, Giovanni

AU - Carella, Angelo M.

AU - Montalbetti, Luigi

AU - Lazzarino, Mario

AU - Morra, Enrica

PY - 2010/2

Y1 - 2010/2

N2 - The aim of this phase II trial was to investigate the efficacy of bortezomib plus dexamethasone (Vel-Dex) as induction therapy in patients with multiple myeloma (MM) and to define the role of intensification before transplantation. Fifty-seven patients were treated with four courses of Vel-Dex, two cycles of dexamethasone, cyclophosphamide, etoposide and cisplatin (DCEP), and a single autologous transplant. Fourteen patients (25) went off-study: seven after Vel-Dex, seven after DCEP. All patients yielded high numbers of stem cells (median CD34 cells 7.5×106/kg); 54 of the 57 patients (94) collected ≥4×106/kg CD34 cells, 60 with a single leukapheresis. The overall response rate (ORR) after Vel-Dex was 86 (70 had a very good partial response [VGPR] or better) regardless of cytogenetic abnormalities and International Staging System stage (ISS). The response at the end of the two DCEP cycles remained unchanged in 35 patients (70), worsened in 15 (20), and improved in 5 (10). Because of the consistent drop-out, the ORR in intention-to-treat analysis decreased significantly from 86 after Vel-Dex to 76 after DCEP, and 73 after transplantation. However, when considering the subset of 43 patients who completed the program, the ORR was 96 (complete response 39, VGPR 41, partial response 16). In conclusion, Vel-Dex produces high response rates, improves stem cell collection, and overcomes the need for intensification before autologous transplantation.

AB - The aim of this phase II trial was to investigate the efficacy of bortezomib plus dexamethasone (Vel-Dex) as induction therapy in patients with multiple myeloma (MM) and to define the role of intensification before transplantation. Fifty-seven patients were treated with four courses of Vel-Dex, two cycles of dexamethasone, cyclophosphamide, etoposide and cisplatin (DCEP), and a single autologous transplant. Fourteen patients (25) went off-study: seven after Vel-Dex, seven after DCEP. All patients yielded high numbers of stem cells (median CD34 cells 7.5×106/kg); 54 of the 57 patients (94) collected ≥4×106/kg CD34 cells, 60 with a single leukapheresis. The overall response rate (ORR) after Vel-Dex was 86 (70 had a very good partial response [VGPR] or better) regardless of cytogenetic abnormalities and International Staging System stage (ISS). The response at the end of the two DCEP cycles remained unchanged in 35 patients (70), worsened in 15 (20), and improved in 5 (10). Because of the consistent drop-out, the ORR in intention-to-treat analysis decreased significantly from 86 after Vel-Dex to 76 after DCEP, and 73 after transplantation. However, when considering the subset of 43 patients who completed the program, the ORR was 96 (complete response 39, VGPR 41, partial response 16). In conclusion, Vel-Dex produces high response rates, improves stem cell collection, and overcomes the need for intensification before autologous transplantation.

KW - Bortezomib

KW - DCEP

KW - High-dose therapy

KW - Induction therapy

KW - Multiple myeloma

KW - Peripheral stem cell collection

UR - http://www.scopus.com/inward/record.url?scp=76349087848&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=76349087848&partnerID=8YFLogxK

U2 - 10.3109/10428190903452826

DO - 10.3109/10428190903452826

M3 - Article

C2 - 20001242

AN - SCOPUS:76349087848

VL - 51

SP - 236

EP - 242

JO - Leukemia and Lymphoma

JF - Leukemia and Lymphoma

SN - 1042-8194

IS - 2

ER -