@article {7729, title = {Characterization of haematological parameters with bortezomib-melphalan-prednisone versus melphalan-prednisone in newly diagnosed myeloma, with evaluation of long-term outcomes and risk of thromboembolic events with use of erythropoiesis-stimulating agent}, journal = {British Journal of Haematology}, volume = {153}, year = {2011}, note = {Cited By :4Export Date: 21 February 2017}, month = {2011}, pages = {212 - 221}, abstract = {Although haematological toxicities, such as anaemia, are common in multiple myeloma (MM), no clear consensus exists on the use and impact of erythropoiesis-stimulating agents (ESA) on outcomes in MM. This analysis characterizes haematological toxicities and associated interventions in the phase III VISTA (Velcade {\textregistered} as Initial Standard Therapy in Multiple Myeloma: Assessment with Melphalan and Prednisone) study of bortezomib plus melphalan/prednisone (VMP, n=344) versus MP (n=338) in previously untreated MM patients ineligible for high-dose therapy, and evaluates the impact of ESA use or red-blood-cell (RBC) transfusions on outcomes and thromboembolic risk. Incidence of haematological toxicities was similar with VMP and MP; similar rates of interventions and associated complications (e.g. bleeding, febrile neutropenia) were observed. Two hundred thirty three patients received ESA; 204 had RBC transfusions. Frequency of thromboembolic events was low and not affected by ESA use. Median time-to progression (TTP) was similar between ESA/non-ESA [hazard ratio: 1{\textperiodcentered}03 (95\% confidence interval 0{\textperiodcentered}76-1{\textperiodcentered}39); P=0{\textperiodcentered}8478] in both arms (VMP: 19{\textperiodcentered}9/not reached; MP: 15{\textperiodcentered}0/17{\textperiodcentered}5months). Three-year overall survival (OS) rates were similar between ESA/non-ESA in each arm. Patients receiving RBC transfusions had significantly shorter OS (P\<0{\textperiodcentered}0001) versus non-RBC-transfusion patients. In conclusion, bortezomib did not add to melphalan haematological toxicity. Concomitant ESA use with VMP/MP in previously untreated MM patients did not adversely affect TTP or OS, or increase thromboembolic risk. However, RBC transfusion was associated with significantly shorter survival. {\textcopyright} 2011 Blackwell Publishing Ltd.}, keywords = {bortezomib, Erythropoiesis-stimulating agents, Melphalan, myeloma, Prednisone}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-79953088636\&doi=10.1111\%2fj.1365-2141.2011.08569.x\&partnerID=40\&md5=90241429ab6b2cca52f901c67832e129}, author = {Richardson, P.G. and Schlag, R. and Khuageva, N. and Dimopoulos, M. and Shpilberg, O. and Kropff, M. and Vekemans, M.-C. and Petrucci, M.T. and Rossiev, V. and Hou, J. and Robak, T. and Mateos, M.-V. and Anderson, K. and Esseltine, D.-L. and Cakana, A. and Liu, K. and Deraedt, W. and van de Velde, H. and San Miguel, J.F.} }