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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

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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.

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Authors and Affiliations

  1. Department of Hematology, Oncology and Hemostaseology, University Clinical Center, University of Leipzig, Leipzig, Germany

    Wolfram Pönisch, Barbara Moll, Malvina Bourgeois, Marc Andrea, Thomas Schliwa, Simone Heyn, Cornelia Becker, Rainer Krahl, Yvonne Remane, Anette Bachmann, Tom Lindner, Lorenz Weidhase, Sirak Petros, Stefan Fricke, Vladan Vucinic, Haifa Al Ali & Dietger Niederwieser

  2. Gemeinschaftspraxis für Hämatologie und Onkologie, Halle, Germany

    Marion Schmalfeld

  3. Medcenter Nordsachsen, Schkeuditz, Germany

    Thomas Edelmann

  4. Praxis für Hämatologie und Onkologie, Leipzig, Germany

    Franz Albert Hoffmann

  5. Praxis für Hämatologie und Onkologie, Dösen, Germany

    Andreas Schwarzer

  6. Clinical Department, Heinrich-Braun-Hospital, III, Zwickau, Germany

    Ute Kreibich

  7. Praxis für Hämatologie und Onkologie, Werdau, Germany

    Matthias Egert

  8. Gemeinschaftspraxis für Hämatologie und Onkologie, Rötha, Germany

    Runa Stiegler

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  1. Wolfram Pönisch
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  2. Barbara Moll
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  3. Malvina Bourgeois
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  4. Marc Andrea
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  10. Franz Albert Hoffmann
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  24. Dietger Niederwieser
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Correspondence to Wolfram Pönisch.

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Pönisch, W., Moll, B., Bourgeois, M. et al. 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. J Cancer Res Clin Oncol 139, 1937–1946 (2013). https://doi.org/10.1007/s00432-013-1513-2

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