Published in:
01-11-2013 | Original Paper
Bendamustine and prednisone in combination with bortezomib (BPV) in the treatment of patients with relapsed or refractory multiple myeloma and light chain-induced renal failure
Authors:
Wolfram Pönisch, Barbara Moll, Malvina Bourgeois, Marc Andrea, Thomas Schliwa, Simone Heyn, Marion Schmalfeld, Thomas Edelmann, Cornelia Becker, Franz Albert Hoffmann, Andreas Schwarzer, Ute Kreibich, Matthias Egert, Runa Stiegler, Rainer Krahl, Yvonne Remane, Anette Bachmann, Tom Lindner, Lorenz Weidhase, Sirak Petros, Stefan Fricke, Vladan Vucinic, Haifa Al Ali, Dietger Niederwieser
Published in:
Journal of Cancer Research and Clinical Oncology
|
Issue 11/2013
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Abstract
Introduction
Serious renal failure represents a severe complication of multiple myeloma (MM), with an estimated 25–50 % of patients being affected. Both bortezomib and bendamustine have been identified as quickly acting, effective and well-tolerated drugs and might therefore constitute an adequate combination regimen for patients presenting with light chain-induced renal failure.
Methods
Between March 2005 and March 2013, 36 patients with relapsed/refractory MM and light chain-induced renal failure (creatinine clearance <60 ml/min) were treated with bendamustine 60 mg/m2 on days 1 and 2, bortezomib 1.3 mg/m2 on days 1, 4, 8 and 11 and prednisone 100 mg on days 1, 2, 4, 8 and 11 (BPV). Patients were divided according to severity of renal impairment into group A (n = 20) with moderate or severe renal dysfunction (eGFR 15–59 ml/min) and group B (n = 16) with renal failure/dialysis (eGFR <15 ml/min).
Results
Twenty-four patients (67 %) responded with three CR, three nCR, six VGPR and 12 PR. Six patients had minor response, two stable and four progressive disease. With a median follow-up period of 22 months, median progression-free survival (PFS) and overall survival (OS) for patients of group A were 10 and 25 months, respectively. This outcome was significantly better compared to patients of group B with a median PFS and OS of 3 and 7 months, respectively. Eleven patients showed a CRrenal, five a PRrenal and 15 a MRrenal.
Summary
These results indicate that this BPV combination is feasible, effective and well tolerated in patients with relapsed/refractory MM and light chain-induced renal failure.