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Successful treatment of patients with newly diagnosed/untreated multiple myeloma and advanced renal failure using bortezomib in combination with bendamustine and prednisone

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Abstract

Purpose

Renal failure is a frequent complication of multiple myeloma (MM) and, if present at diagnosis, a considerable risk factor for outcome. Treatment with chemotherapy and/or new agents may result in recovery of renal function in up to 50 % of patients. The window of opportunity to reverse renal impairment is, however, rather small, making an immediate and highly active treatment strategy mandatory. Bortezomib as well as bendamustine has been demonstrated to be potent drugs in the treatment of MM.

Methods

A total of 18 patients with newly diagnosed/untreated MM and renal insufficiency (GFR < 35 ml/min) were treated with bendamustine, prednisone, and bortezomib (BPV).

Results

The majority of them (n = 15; 83 %) responded after at least one cycle of chemotherapy with three sCR, five nCR, five VGPR, and two PR. With a median follow-up of 17 months, PFS at 18 months was 57 % and OS was 61 %. The myeloma protein decreased rapidly, reaching the best response after the first cycle in four and after the second cycle in additional seven patients. Thirteen patients (72 %) improved their renal function after treatment.

Conclusion

We conclude that the combination of bortezomib, bendamustine, and prednisone is effective and well tolerated in patients with a newly diagnosed MM and renal failure.

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Authors and Affiliations

  1. University of Leipzig, Leipzig, Germany

    Wolfram Pönisch, Marc Andrea, Ina Wagner, Doreen Hammerschmidt, Ute Kreibich, Andreas Schwarzer, Thomas Zehrfeld, Maik Schwarz, Cornelia Winkelmann, Sirak Petros, Anette Bachmann, Tom Lindner & Dietger Niederwieser

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  1. Wolfram Pönisch
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  2. Marc Andrea
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  3. Ina Wagner
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  4. Doreen Hammerschmidt
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Correspondence to Wolfram Pönisch.

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Pönisch, W., Andrea, M., Wagner, I. et al. Successful treatment of patients with newly diagnosed/untreated multiple myeloma and advanced renal failure using bortezomib in combination with bendamustine and prednisone. J Cancer Res Clin Oncol 138, 1405–1412 (2012). https://doi.org/10.1007/s00432-012-1212-4

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