Abstract
The effect of bortezomib on bone remodelling was evaluated in 34 relapsed myeloma patients. At baseline, patients had increased serum concentrations of dickkopf-1 (DKK-1), soluble receptor activator of nuclear factor-kappaB ligand (sRANKL), sRANKL/osteoprotegerin ratio, C-telopeptide of type-I collagen (CTX) and tartrate-resistant acid phosphatase isoform-5b (TRACP-5b); bone-alkaline phosphatase and osteocalcin were reduced. Serum DKK-1 correlated with CTX and severe bone disease. Bortezomib administration significantly reduced serum DKK-1, sRANKL, CTX, and TRACP-5b after four cycles, and dramatically increased bone-alkaline phosphatase and osteocalcin, irrespective of treatment response. This is the first study showing that bortezomib reduces DKK-1 and RANKL serum levels, leading to the normalisation of bone remodelling in relapsed myeloma.
MeSH terms
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Acid Phosphatase / blood
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Adult
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Aged
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Aged, 80 and over
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Alkaline Phosphatase / blood
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Biomarkers / blood
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Bone Remodeling / drug effects*
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Boronic Acids / therapeutic use*
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Bortezomib
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Case-Control Studies
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Collagen Type I / blood
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Diphosphonates / therapeutic use
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Female
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Humans
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Imidazoles / therapeutic use
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Intercellular Signaling Peptides and Proteins / blood*
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Isoenzymes / blood
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Male
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Middle Aged
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Multiple Myeloma / blood
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Multiple Myeloma / drug therapy*
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Osteocalcin / blood
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Osteoprotegerin / blood
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Peptides / blood
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Protease Inhibitors / therapeutic use*
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Pyrazines / therapeutic use*
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RANK Ligand / blood*
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Recurrence
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Statistics, Nonparametric
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Tartrate-Resistant Acid Phosphatase
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Zoledronic Acid
Substances
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Biomarkers
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Boronic Acids
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Collagen Type I
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DKK1 protein, human
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Diphosphonates
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Imidazoles
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Intercellular Signaling Peptides and Proteins
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Isoenzymes
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Osteoprotegerin
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Peptides
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Protease Inhibitors
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Pyrazines
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RANK Ligand
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collagen type I trimeric cross-linked peptide
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Osteocalcin
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Bortezomib
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Zoledronic Acid
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Alkaline Phosphatase
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ACP5 protein, human
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Acid Phosphatase
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Tartrate-Resistant Acid Phosphatase