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The MM Hub were delighted to attend the 44th Annual Meeting of the European Society for Blood and Marrow Transplantation held in Lisbon, Portugal, from 18–21 March 2018. On Monday 19 March 2018 the oral abstract session 4 was held. The session was moderated by Catarina Geraldes, from the University of Coimbra, Portugal and Tamás Masszi, from Semmelweis University, Budapest, Hungary.
The fourth talk of this session was presented by Jose Antonio Pérez-Simón, from the Department of Hematology, Hospital Universitario Virgen del Rocío (IBIS), Seville, Spain with the title: European myeloma network phase I trial on RIC allogeneic transplantation: an optimized program for high risk relapsed myeloma patients. The aim of this study was to evaluate the safety and efficacy of bortezomib used within the reduced intensity conditioning (RIC) regimen, as well as soon after allogeneic transplantation (allo trx) in high-risk and relapsed multiple myeloma (MM) patients.
Bortezomib has been shown to specifically inhibit NFкβ, inducing a selective pro-apoptotic effect on allo-reactive T cells. Previous murine studies have shown that a combination of bortezomib and sirolimus (siro) has a synergistic effect, decreasing the production of pro-inflammatory cytokines, leading to an increased survival rate and could, therefore, be used for graft versus host disease (GvHD) prophylaxis.
To conclude, the addition of bortezomib to a RIC based on fludarabine is safe, allowing good disease control after transplant. Additionally, the combination of bortezomib, sirolimus, and tacrolimus displayed a good toxicity profile with an incredible efficacy in terms of GvHD prevention. However, it is important to stress the need for maintenance therapy with the use of new drugs and transplant in earlier stages of the disease in order to improve outcome.
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