Clinical Pearls in Blood Diseases
Predictive value of alkaline phosphatase for response and time to progression in bortezomib-treated multiple myeloma patients
Article first published online: 1 JUN 2007
Copyright © 2007 Wiley-Liss, Inc.
American Journal of Hematology
Volume 82, Issue 9, pages 831–833, September 2007
How to Cite
Zangari, M., Esseltine, D., Cavallo, F., Neuwirth, R., Elice, F., Burns, M. J., Yaccoby, S., Richardson, P., Sonneveld, P. and Tricot, G. (2007), Predictive value of alkaline phosphatase for response and time to progression in bortezomib-treated multiple myeloma patients. Am. J. Hematol., 82: 831–833. doi: 10.1002/ajh.20961
- Issue published online: 6 AUG 2007
- Article first published online: 1 JUN 2007
- Manuscript Accepted: 16 MAR 2007
- Manuscript Revised: 13 MAR 2007
- Manuscript Received: 22 JAN 2007
Myeloma bone disease is characterized by osteolytic destruction associated with suppressed osteoblastic activity. Using data from the APEX (Richardson et al., N Engl J Med 2005;352:2487–2498) study, we have assessed the relationship of changes in alkaline phosphatase (ALP) levels during bortezomib therapy with response and time to progression on this therapy. The percentage of ALP increments in responders (complete and partial response) and nonresponders was analyzed at different thresholds and time points. For all bortezomib-treated patients enrolled in the trial (N = 333), at least a 25% increase in ALP from the baseline at 6 week was the most powerful predictor of treatment response (P < 0.0001) and time to progression (206 vs. 169 days) relative to patients with less than a 25% increase in ALP (P = 0.01). Markers of osteoblastic activation may predict quality and duration of response in multiple myeloma. In addition, our data suggest that bone anabolism could inhibit myeloma growth. Am. J. Hematol., 2007. © 2007 Wiley-Liss, Inc.