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High serum bone-specific alkaline phosphatase level after bortezomib-combined therapy in refractory multiple myeloma: possible role of bortezomib on osteoblast differentiation

Leukemia volume 19, pages 1102–1103 (2005)Cite this article

TO THE EDITOR

Bone disease in multiple myeloma (MM) is characterized by increased bone resorption and impaired osteoblast activity, resulting in lytic bone lesions.1 Therefore, the biochemical markers of osteoblastic activity seem not elevated in most cases of MM. Recently, bortezomib, a proteasome inhibitor, has been shown to have an antimyeloma activity by blocking nuclear factor-κB (NF-κB)-mediated IL-6 production from bone marrow (BM) microenvironment, and inducing apoptosis of myeloma cells.2 It acts in the BM microenvironment to inhibit the binding of myeloma cells to BM stromal cells, the transcription and secretion of IL-6 triggered by myeloma cells to BM stromal cell adhesion, and BM angiogenesis. Phase II trial of bortezomib in patients with refractory MM demonstrated the overall response rate of 35%, with 10% of patients being in complete response (CR).3 However, the effect of bortezomib on bone lesions remains unknown. We here report a patient with MM who showed the high serum total alkaline phosphatase (ALP) as well as bone-specific alkaline phosphatase (BAP) levels after bortezomib-combined therapy, which suggests that bortezomib induced osteoblastic differentiation.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    C Shimazaki, R Uchida, S Nakano, K Namura, S-i Fuchida, A Okano & M Okamoto

  2. Department of Molecular Genetics and Laboratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    T Inaba

Authors
  1. C Shimazaki
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  2. R Uchida
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  3. S Nakano
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  4. K Namura
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  5. S-i Fuchida
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  6. A Okano
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  7. M Okamoto
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  8. T Inaba
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Correspondence to C Shimazaki.

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Shimazaki, C., Uchida, R., Nakano, S. et al. High serum bone-specific alkaline phosphatase level after bortezomib-combined therapy in refractory multiple myeloma: possible role of bortezomib on osteoblast differentiation. Leukemia 19, 1102–1103 (2005). https://doi.org/10.1038/sj.leu.2403758

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  • DOI: https://doi.org/10.1038/sj.leu.2403758

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