Stromal cells in bone marrow play important roles in pro-inflammatory cytokine secretion causing fever following bortezomib administration in patients with multiple myeloma

Int J Hematol. 2008 Nov;88(4):396-402. doi: 10.1007/s12185-008-0194-0. Epub 2008 Nov 7.

Abstract

Bortezomib blocks the activation of nuclear factor-kappaB-mediated pro-inflammatory cytokines, however, systemic inflammatory symptoms following bortezomib administration have been reported, although their mechanisms remain elusive. Serum samples were obtained from five patients, who participated in a phase I/II study of Japanese patients with relapsed or refractory multiple myeloma (MM), and developed cyclic fever following bortezomib administration, to measure cytokine levels. Significant correlations between interleukin (IL)-6 or interferon (IFN)-gamma and the body temperature were observed in two patients each. Furthermore, we found that IL-6 elevation was not observed after the addition of bortezomib to any examined MM cells alone, but was noted in a case of bone marrow stromal cells (BMSCs) of macrophage origin alone or co-cultured with MM cells. Similarly, a marked increase in IFN-gamma levels was induced by adding bortezomib to BMSCs of fibroblast origin. Although this investigation was a preliminary study with a small number of patients, our results suggested that pro-inflammatory cytokines causing bortezomib-associated fever were secreted from BMSCs rather than MM cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Bone Marrow Cells / metabolism*
  • Boronic Acids / administration & dosage
  • Boronic Acids / adverse effects*
  • Bortezomib
  • Cell Line, Tumor
  • Cytokines / blood*
  • Cytokines / metabolism
  • Female
  • Fever / blood*
  • Fever / chemically induced*
  • Humans
  • Inflammation Mediators / blood*
  • Male
  • Middle Aged
  • Multiple Myeloma / blood*
  • Multiple Myeloma / drug therapy
  • Pyrazines / administration & dosage
  • Pyrazines / adverse effects*
  • Stromal Cells / metabolism

Substances

  • Antineoplastic Agents
  • Boronic Acids
  • Cytokines
  • Inflammation Mediators
  • Pyrazines
  • Bortezomib