First-line therapy with thalidomide, dexamethasone and zoledronic acid decreases bone resorption markers in patients with multiple myeloma

Patrizia Tosi, Elena Zamagni, Claudia Cellini, Raffaele Parente, Delia Cangini, Paola Tacchetti, Giulia Perrone, Michela Ceccolini, Paola Boni, Sante Tura, Michele Baccarani, Michele Cavo

Research output: Contribution to journalArticle

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Abstract

Background: Bone involvement is frequently observed in multiple myeloma (MM) patients both at diagnosis and during the course of the disease. The evaluation of biochemical markers of bone turnover could allow a dynamic evaluation of the effects of a given therapy on bone metabolism. Methods: In the present study, markers of bone resorption [urinary free pyridinoline (PYD), deoxypyridinoline (DPYD), N-terminal telopeptide of collagen I (NTX) and C-terminal telopeptide (serum crosslaps)] and of bone formation [bone alkaline phosphatase (BAP) and osteocalcin] were evaluated at diagnosis and after induction therapy in 40 patients (23M, 17F, median age = 53.5 yr) enrolled in the 'Bologna 2002' clinical trial. By study design, all patients received 4 months of combined thalidomide (100 mg/d for 2 wk then 200 mg/d), dexamethasone (40 mg/d on days 1-4, 9-12, 17-20/28 on odd cycles and on days 1-4 on even cycles) and zoledronic acid (4 mg/28 d). Results: At diagnosis, although bone resorption markers were increased in more than 40% of the patients, only NTX (P = 0.029) and crosslaps (P = 0.000) were significantly related to the extent of skeletal lesions, as assessed by X-ray. After 4 months of therapy, a significant decrease in mean (±SE) urinary NTX (52.7 ±6.9 nmol/mmol creatinine ±6.9 vs. 14 ± 1.42 nmol/mmol creatinine, P = 0.000) and serum crosslaps (6242.4 ±945 pmol/L vs. 1414.9 ± 173.8 pmol/L, P = 0.000) was observed in patients obtaining ≥partial response, at variance to what has been detected in patients showing

Original languageEnglish
Pages (from-to)399-404
Number of pages6
JournalEuropean Journal of Haematology
Volume76
Issue number5
DOIs
Publication statusPublished - May 2006

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zoledronic acid
glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine
Thalidomide
Bone Resorption
Multiple Myeloma
Dexamethasone
Bone and Bones
Creatinine
Therapeutics
Bone Remodeling
Osteocalcin
Serum
Osteogenesis
Alkaline Phosphatase
Biomarkers
X-Rays
Clinical Trials

Keywords

  • Bone turnover
  • Multiple myeloma
  • Thalidomide
  • Zoledronic acid

ASJC Scopus subject areas

  • Hematology

Cite this

First-line therapy with thalidomide, dexamethasone and zoledronic acid decreases bone resorption markers in patients with multiple myeloma. / Tosi, Patrizia; Zamagni, Elena; Cellini, Claudia; Parente, Raffaele; Cangini, Delia; Tacchetti, Paola; Perrone, Giulia; Ceccolini, Michela; Boni, Paola; Tura, Sante; Baccarani, Michele; Cavo, Michele.

In: European Journal of Haematology, Vol. 76, No. 5, 05.2006, p. 399-404.

Research output: Contribution to journalArticle

Tosi, P, Zamagni, E, Cellini, C, Parente, R, Cangini, D, Tacchetti, P, Perrone, G, Ceccolini, M, Boni, P, Tura, S, Baccarani, M & Cavo, M 2006, 'First-line therapy with thalidomide, dexamethasone and zoledronic acid decreases bone resorption markers in patients with multiple myeloma', European Journal of Haematology, vol. 76, no. 5, pp. 399-404. https://doi.org/10.1111/j.0902-4441.2005.t01-1-EJH2520.x
Tosi, Patrizia ; Zamagni, Elena ; Cellini, Claudia ; Parente, Raffaele ; Cangini, Delia ; Tacchetti, Paola ; Perrone, Giulia ; Ceccolini, Michela ; Boni, Paola ; Tura, Sante ; Baccarani, Michele ; Cavo, Michele. / First-line therapy with thalidomide, dexamethasone and zoledronic acid decreases bone resorption markers in patients with multiple myeloma. In: European Journal of Haematology. 2006 ; Vol. 76, No. 5. pp. 399-404.
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abstract = "Background: Bone involvement is frequently observed in multiple myeloma (MM) patients both at diagnosis and during the course of the disease. The evaluation of biochemical markers of bone turnover could allow a dynamic evaluation of the effects of a given therapy on bone metabolism. Methods: In the present study, markers of bone resorption [urinary free pyridinoline (PYD), deoxypyridinoline (DPYD), N-terminal telopeptide of collagen I (NTX) and C-terminal telopeptide (serum crosslaps)] and of bone formation [bone alkaline phosphatase (BAP) and osteocalcin] were evaluated at diagnosis and after induction therapy in 40 patients (23M, 17F, median age = 53.5 yr) enrolled in the 'Bologna 2002' clinical trial. By study design, all patients received 4 months of combined thalidomide (100 mg/d for 2 wk then 200 mg/d), dexamethasone (40 mg/d on days 1-4, 9-12, 17-20/28 on odd cycles and on days 1-4 on even cycles) and zoledronic acid (4 mg/28 d). Results: At diagnosis, although bone resorption markers were increased in more than 40{\%} of the patients, only NTX (P = 0.029) and crosslaps (P = 0.000) were significantly related to the extent of skeletal lesions, as assessed by X-ray. After 4 months of therapy, a significant decrease in mean (±SE) urinary NTX (52.7 ±6.9 nmol/mmol creatinine ±6.9 vs. 14 ± 1.42 nmol/mmol creatinine, P = 0.000) and serum crosslaps (6242.4 ±945 pmol/L vs. 1414.9 ± 173.8 pmol/L, P = 0.000) was observed in patients obtaining ≥partial response, at variance to what has been detected in patients showing",
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AU - Zamagni, Elena

AU - Cellini, Claudia

AU - Parente, Raffaele

AU - Cangini, Delia

AU - Tacchetti, Paola

AU - Perrone, Giulia

AU - Ceccolini, Michela

AU - Boni, Paola

AU - Tura, Sante

AU - Baccarani, Michele

AU - Cavo, Michele

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N2 - Background: Bone involvement is frequently observed in multiple myeloma (MM) patients both at diagnosis and during the course of the disease. The evaluation of biochemical markers of bone turnover could allow a dynamic evaluation of the effects of a given therapy on bone metabolism. Methods: In the present study, markers of bone resorption [urinary free pyridinoline (PYD), deoxypyridinoline (DPYD), N-terminal telopeptide of collagen I (NTX) and C-terminal telopeptide (serum crosslaps)] and of bone formation [bone alkaline phosphatase (BAP) and osteocalcin] were evaluated at diagnosis and after induction therapy in 40 patients (23M, 17F, median age = 53.5 yr) enrolled in the 'Bologna 2002' clinical trial. By study design, all patients received 4 months of combined thalidomide (100 mg/d for 2 wk then 200 mg/d), dexamethasone (40 mg/d on days 1-4, 9-12, 17-20/28 on odd cycles and on days 1-4 on even cycles) and zoledronic acid (4 mg/28 d). Results: At diagnosis, although bone resorption markers were increased in more than 40% of the patients, only NTX (P = 0.029) and crosslaps (P = 0.000) were significantly related to the extent of skeletal lesions, as assessed by X-ray. After 4 months of therapy, a significant decrease in mean (±SE) urinary NTX (52.7 ±6.9 nmol/mmol creatinine ±6.9 vs. 14 ± 1.42 nmol/mmol creatinine, P = 0.000) and serum crosslaps (6242.4 ±945 pmol/L vs. 1414.9 ± 173.8 pmol/L, P = 0.000) was observed in patients obtaining ≥partial response, at variance to what has been detected in patients showing

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