Use of bortezomib in the management of chronic graft-versus-host disease among multiple myeloma patients relapsing after allogeneic transplantation

Abstract

We report on the use of bortezomib for the management of chronic graft versus host disease (cGVHD) among 8 multiple myeloma (MM) patients who relapsed after reduced-intensity conditioning (RIC) allogeneic transplantation. Five patients (62%) responded to bortezomib demonstrating anti-myeloma effect. Four patients had active cGVHD, including 3 patients with severe punctate keratopathy, at the time of bortezomib administration. All showed an improvement in their condition. This is the first report showing that bortezomib may be useful in the management of cGVHD and related ocular involvement.

Lenalidomide as salvage treatment for multiple myeloma relapsing after allogeneic hematopoietic stem cell transplantation: a report from the French Society of Bone Marrow and Cellular Therapy

“…12 These data also suggest a higher efficacy of lenalidomide in comparison to thalidomide (ORR 29%) 6 and at least a comparable efficacy to that of bortezomib (ORR 61-73%). [16][17][18] With a median follow up of 16.3 months, the median PFS was 18 months and the median OS was 30.5 months; results that appear superior to those reported with thalidomide (median OS of 12 months) 6 and bortezomib (median PFS of 6 months) 16,17 within comparable settings. In our cohort, the only significant factor influencing PFS and OS was abnormal cytogenetics.…”

Selective apoptosis of monocytes and monocyte-derived DCs induced by bortezomib (Velcade)

“…32 In animal models of GVHD, Bortezomib administration has been shown to prevent GVHD, 9,10 although in neither study were its effects on APC numbers and function tested. In addition, in a recent small study 33 Bortezomib has shown some efficacy in the management of chronic GVHD. However, no data have been reported as yet on monocyte and DC numbers in the peripheral blood or tissues of patients receiving Bortezomib in this as well as other studies.…”

Proteasomal Regulation of Pulmonary Fibrosis

“…There are reports, however, on the efficacy of bortezomib in the treatment of chronic graft-versus-host disease (66,67). In animal models, inhibition of TGF-b1 signaling has been shown to decrease the severity of chronic graft-versus-host disease and the severity of bronchiolitis obliterans after allogeneic hematopoietic stem cell transplant (24,68).…”