• Jorge E Romaguera, Luis E Fayad, Peter McLaughlin, Barbara Pro, Alma Rodriguez, Michael Wang, Pamela Weaver, Kimberly Hartig, Larry W Kwak, Tatyana Feldman, Judy Smith, Peggy Ford, Stuart Goldberg, Andrew Pecora, and Andre Goy.
• Department of Lymphoma/Myeloma, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd. #429, Houston, TX 77030, USA. jromague@mdanderson.org
• Br. J. Haematol. 2010 Oct 1; 151 (1): 47-53.

AbstractMantle cell lymphoma (MCL) outcomes have improved over the last two decades; however, late relapses occur. Bortezomib has shown single agent activity of 33% in relapsed MCL and has an additive/synergistic effect in vitro when combined with drugs currently used to treat MCL. We hypothesized that a combination of bortezomib with current intense non-transplant chemoimmunotherapy might prevent late relapses. The toxicity of bortezomib when combined with methotrexate and cytarabine is unknown. Patients aged 18-79 years with untreated aggressive MCL were treated with R-HyperCVAD (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) alternating with rituximab-methotrexate/cytarabine (R-M/A). Bortezomib was added to the R-Hyper-CVAD combination as a fixed dose of 1·3 mg/m(2) IV on days 2 and 5 and was added to the R-M/A regimen after rituximab, in increasing doses of 0·7, 1, and 1·3 mg/m(2) in cohorts of three patients. Twenty patients were assessed for toxicity of the regimen. The principal toxicity was haematological and did not differ from that observed with a similar regimen without the bortezomib. In particular, there was no pulmonary or neurological dose-limiting toxicity, showing that bortezomib can be safely combined with R-HyperCVAD and R-M/A.© 2010 Blackwell Publishing Ltd.

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