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Korean J Med > Volume 88(5); 2015 > Article
혈액종양
The Korean Journal of Medicine 2015;88(5): 537-546.
불응성/재발성 다발골수종의 볼테조밉 구제 치료의 실제: 단일 기관의 경험
김동현, 이지현, 김성현, 오성용, 이수이, 문상이, 김효진
동아대학교 의과대학 내과학교실
Bortezomib-Based Salvage Chemotherapy in Refractory/Relapsed Multiple Myeloma Patients: A Single Center Experience in Real Clinical Practice
Dong Hyun Kim, Ji Hyun Lee, Sung-Hyun Kim, Sung Yong Oh, Suee Lee, Sang Yi Moon, Hyo-Jin Kim
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
Corresponding Author: Hyo-Jin Kim ,Tel: +82-51-240-2951, Fax: +82-51-246-5044, Email: kimhj@dau.ac.kr
Received: September 24, 2014;   Revised: October 20, 2014;   Accepted: October 30, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background/Aims:
Bortezomib-based chemotherapy has proven to be an effective salvage regimen for refractory/relapsed multiple myeloma patients in many clinical trials. However, few reports have shown the outcomes and adverse events of bortezomib-based salvage chemotherapy in clinical practice.
Methods:
From April 2006 to September 2011, 37 patients were retrospectively analyzed. A total of 19 patients received bortezomib therapy and 18 patients received bortezomib plus dexamethasone therapy.
Results:
The median follow-up duration was 18.13 months (range, 0.97-87.20 months). The median number of cycles administered was four (range, 1-13). The overall response rate by International Myeloma Working Group (IMWG) 2006 criteria was 64.9%, including six complete responses (16.2%). The median number of cycles to best response was three (95% confidence interval [CI], 1.36-4.64). Six patients achieved their best responses after four cycles of bortezomib therapy. The median time to progression and overall survival were 5.10 (95% CI 4.03-6.17), and 23.10 (95% CI, 9.24-36.96) months, respectively. The incidence of grade 3/4 neutropenia and thrombocytopenia was 29.7% and 64.9%, respectively. A total of 27.0% patients experienced grade 3 peripheral neuropathy. Herpes zoster developed in 11 patients (29.7%). Treatment was stopped in 22 patients (59.5%) due to adverse events after bortezomib-based therapy, and treatment-related mortality occurred in 4 of 25 deaths in total.
Conclusions:
Bortezomib-based therapy is a very effective salvage regimen in real clinical practice, although patients relapse after multiple chemotherapies. Despite intolerable in some patients, management of toxicities and extended cycles of therapy could benefit more patients, resulting in higher response rates.
Keywords: Multiple myeloma; Bortezomib; Salvage therapy
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