Skip to Main content Skip to Navigation
Journal articles

Bortezomib-doxorubicin-cyclophosphamide-dexamethasone induction followed by stem cell transplantation for primary plasma cell leukemia: a prospective phase II study of the IFM

Bruno Royer 1 Minvielle Stéphane 2 Momar Diouf 3 Murielle Roussel 4 Lionel Karlin 5 Cyrille Hulin 6 Bertrand Arnulf 7 Margaret Macro 8 Cailleres Sylvie 9 Annie Brion 10 Sabine Bréchignac 11 Beladj Karim 12 Marie Lorraine Chrétien 13 Marc Wetterwald 14 Carine Chaleteix 15 Mourad Tiab 16 Xavier Leleu 17, 18 Laurent Frenzel 19 Laurent Garderet 20 Sylvain Choquet 21 Jean-Gabriel Fuzibet 22 Charles Dauriac 23 Luc-Matthieu Forneker 24 Lotfi Benboubker 25 Thierry Facon 26 Philippe Moreau 27 Hervé Avet-Loiseau 28 Jean-Pierre Marolleau 29 
Abstract : Purpose Primary plasma cell leukemia (pPCL) is a rare and aggressive malignancy with a poor prognosis. With conventional chemotherapy, patients typically die within 1 year. In all but one of the retrospective studies reported to date, bortezomib and lenalidomide seem to improve survival. We conducted a prospective phase II trial in patients with pPCL to assess the efficacy of an alternate regimen that combines standard chemotherapy, a proteasome inhibitor, and high-dose melphalan and autologous stem cell transplantation (HDM/ASCT) followed by either allogeneic transplantation or bortezomib/lenalidomide maintenance. Patients and Methods Patients 70 years old and younger with newly diagnosed pPCL received four alternating cycles of bortezomib, dexamethasone plus doxorubicin or cyclophosphamide. Peripheral blood stem cells were collected from responding patients with < 1% of circulating plasma cells before HDM/ASCT. As consolidation, young patients received a reduced-intensity conditioning allograft, whereas the remaining patients underwent a second HDM/ASCT followed by 1 year of bortezomib, lenalidomide, dexamethasone. The primary end point was progression-free survival (PFS). Results Forty patients (median age, 57 years; range, 27 to 71 years) were enrolled. The median follow-up was 28.7 months. In the intention-to-treat analysis, the median PFS and overall survival were 15.1 (95% CI, 8.4; -) and 36.3 (95% CI, 25.6; -) months, respectively. The overall response rate to induction was 69%. One patient underwent a syngeneic allograft and 25 HDM/ASCT (16 of whom subsequently received a reduced-intensity conditioning allograft and seven a second ASCT followed by maintenance). Conclusion In this prospective trial in patients with pPCL, we show that bortezomib, dexamethasone plus doxorubicin or cyclophosphamide induction followed by transplantation induces high response rates and appears to significantly improve PFS.
Document type :
Journal articles
Complete list of metadata

Cited literature [6 references]  Display  Hide  Download
Contributor : Elizabeth Bernardo Connect in order to contact the contributor
Submitted on : Friday, February 12, 2016 - 12:30:21 PM
Last modification on : Thursday, August 4, 2022 - 5:25:59 PM
Long-term archiving on: : Saturday, November 12, 2016 - 7:35:06 PM


 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document



Bruno Royer, Minvielle Stéphane, Momar Diouf, Murielle Roussel, Lionel Karlin, et al.. Bortezomib-doxorubicin-cyclophosphamide-dexamethasone induction followed by stem cell transplantation for primary plasma cell leukemia: a prospective phase II study of the IFM. Journal of Clinical Oncology, American Society of Clinical Oncology, 2016, 34 (18), pp.2125-2132. ⟨10.1200/JCO.2015.63.1929⟩. ⟨inserm-01273359⟩



Record views