EFFICIENCY OF THERAPY HEMODIALYSIS PATIENTS WITH MULTIPLE MYELOMA AND RENAL FAILURE BY BORTEZOMIB PROTOCOLS

The efficiency of bortezomib protocols is evaluated in 27 patients with multiple myeloma and renal failure. The mean serum creatinine level in those patients was 642 +/- 55 mmol/liter, glomerular filtration 14.9 +/- 1.3 ml/min. Combined therapy by bortezomib protocols and hemodyalisis was carried out in 14 patients, 13 patients received cytostatic therapy alone. Antitumor response, recovery of renal function parameters, and overall survival were evaluated. Patients receiving antitumor bortezomib therapy in combination with hemodialysis exhibited an objective antitumor response of 63.3%, with substitute renal therapy of 1 to 42 months (median 6 months). Renal function values improved significantly after 6 months of treatment. The need in hemodialysis persisted in 8 (57.2%) patients, in 2 (14.3%) patients hemodialysis had to be resumed after its discontinuation, and no more hemodialysis was needed in 4 (28.5%) patients. The objective response in patients receiving only antitumor bortezomib therapy was virtually the same as in hemodialysis subgroup -61.5%. Renal function improved as well. Survival median in the subgroups was 50 and 48 months, respectively. The study has demonstrated high efficiency of bortezomib protocols for the treatment of patients with multiple myeloma complicated by renal failure. Antitumor therapy was supplemented by hemodialysis in patients with glomerular filtration below 20 ml/min.