Tuesday, February 7, 2012

The Clinical Observation of Bortezomib Used in Relapsed or ...

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Cancer Research

[Abstract]

Background Bortezomib, which is the first proteasome inhibitor to enter clinical trials, has been widely used for patients with refractory and relapsed hematological malignancy, such as multiple myeloma, lymphoma and leukemia. As it is reported, there is 30-50% response in bortezomib treatment of multiple myeloma. In recent, bortezomib has also shown encouraging results in mantle cell lymphoma, follicular and marginal zone lymphoma. The common complications of bortezomib are weakness, thrombocytopenia, diarrhea, and peripheral neuropathy, et al. It is a safe and effective antitumor medicine.Objective To investigate the efficacy and toxicity of bortezomib for the treatment of patients with relapsed or refractory hematological malignancy.Methods Nineteen patients with refractory or relapsed hematological malignancy (fifteen of multiple myeloma, three of lymphoma,one of acute leukemia) received bortezomib (1.3mg/m~2) on days 1, 4, 8, and 11 of a3-week cycle. Patients of multiple myeloma received dexamethasone 30mg/40mg on the days 1 to2, 4 to 5, 8 to 9 and 11 tol2 simultaneously. The combination with liposomol doxorubicin on day 4 was used in three patients of lymphoma. The patient of acute myeloblastic leukemia received bortezomib in combination with amsacrine on days 1,4,8,11. Response to bortezomib was evaluated according to the criteria Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria.Results Clinical response was observed in 13 patients(84.2%),including near complete response in 5, partial response in 8, minimal respo nse in 3 and no response in 3. The most common adverse events were gastrointestinal symptoms, thrombocytopenia and neuropathy et al. The adverse events were subsided on routine supportive care. A remarkable observation in our treatment was the high incidence of varicella herpes zoster. Seven out of nineteen patients developed varicella herpes zoster.Conclusions1. Bortezomib is an effective therapy with a high response rate for patients with hematological malignancy.2. The combination of bortezomib is better than the sole use.3. The side effects are manageable, but sometimes severe.4. The high incidence of varicella herpes zoster was observed and the mechanism is unclear.

Title: The Clinical Observation of Bortezomib Used in Relapsed or Refractory Hematologic Malignancy

Category: Liver Cancer

Filename: The Clinical Observation of Bortezomib Used in Relapsed or Refractory Hematologic Malignancy.pdf

Pages: 190

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