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Autografting

Bortezomib administered pre-auto-SCT and as maintenance therapy post transplant for multiple myeloma: a single institution phase II study

Bone Marrow Transplantation volume 43, pages 793–800 (2009)Cite this article

Abstract

The appropriate induction therapy before and the role of maintenance therapy after auto-SCT for patients with multiple myeloma remain areas of active investigation. We conducted a study in 40 patients with bortezomib given sequentially pre-auto-SCT and as maintenance therapy post auto-SCT. Pre-transplant bortezomib was administered for two cycles followed by high-dose melphalan 200 mg/m2 with auto-SCT of G-CSF-mobilized PBMCs. Post transplant bortezomib was administered weekly for 5 out of 6 weeks for six cycles. No adverse effects were observed on stem cell mobilization or engraftment. An overall response rate of 83% with a CR+very good partial remission (VGPR) of 50% was observed with this approach. Three-year Kaplan–Meier estimates of disease-free survival and overall survival (OS) were 38.2 and 63.1%, respectively. Bortezomib reduced CD8+ cytotoxic T cell and CD56+ natural killer cell PBL subsets and was clinically associated with high rates of viral reactivation to varicella zoster.

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Acknowledgements

Research funding and bortezomib for the clinical trial were provided by Millennium Pharmaceuticals.

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  1. Division of Oncology, Section of Bone Marrow Transplantation and Leukemia, Washington University School of Medicine, St Louis, MO, USA

    G L Uy, S D Goyal, N M Fisher, A Y Oza, M H Tomasson, K Stockerl-Goldstein, J F DiPersio & R Vij

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  1. G L Uy
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Correspondence to G L Uy.

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Uy, G., Goyal, S., Fisher, N. et al. Bortezomib administered pre-auto-SCT and as maintenance therapy post transplant for multiple myeloma: a single institution phase II study. Bone Marrow Transplant 43, 793–800 (2009). https://doi.org/10.1038/bmt.2008.384

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