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Changes in Osteoblastic Activity in Patient Who Received Bortezomib as Second Line Treatment for Plasma Cell Myeloma: A Prospective Multicenter Study

Authors
Eom, Ki-SeongKim, Seok JinLee, Je-JungSuh, CheolwonKim, Jin SeokYoon, Sung-SooKim, Byung SooKang, Hye JinChoi, Young JinKim, Chul SooKim, Yang SooKwak, Jae-YongKim, Yoo JinJoo, Young DonMun, Yeung-ChulJo, Deog YeonPark, Joon SeongPark, Chi-YoungKim, Sung-HyunMin, Chang-Ki
Issue Date
2014
Publisher
HINDAWI LTD
Citation
BIOMED RESEARCH INTERNATIONAL, v.2014
Indexed
SCIE
SCOPUS
Journal Title
BIOMED RESEARCH INTERNATIONAL
Volume
2014
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/133541
DOI
10.1155/2014/245247
ISSN
2314-6133
Abstract
We conducted a prospective multicenter study identifying the role of bortezomib in patients with relapsed or refractory plasma cell myeloma (PCM) in bone resorption and formation via bone turnover markers. A total of 104 patients received at least 1 cycle of bortezomib. Most of them had advanced disease (n = 89). Among them, 75 patients completed 4 cycles of treatment. Most of the patients (81.7%) were treated in combination with steroid. After the 4th cycle treatment, 47 of 75 patients achieved CR, nCR, VGPR, and PR (64.4%), while 26 patients achieved less than PR (35.6%). The proportion of patients who achieved >= PR increased as patients received more treatment cycles, reaching 90% after the 8th cycle. DKK-1 levels decreased significantly posttreatment. Bone formation markers (bALP and OC) and osteoclast regulator such as sRANKL also decreased significantly. These findings were observed primarily in patients who received steroid and who had a longer disease duration. While sRANKL demonstrated significant reduction posttreatment, osteoprotegerin (OPG) level did not significantly change posttreatment, resulting in a decreased sRANKL/OPG ratio (P = 0.037). In conclusion, our clinical data suggest that treatment with bortezomib and steroid may rearrange the metabolic balance between osteoblast and osteoclast activities in PCM.
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