Bortezomib and Busulfan Offers New Multiple Myeloma Treatment

The bone marrow is the factory of the body’s necessary red and white blood cells, as well as platelets, which form from myeloid or lymphoid progenitor cells. Overproduction and suppression of myeloid stem cells can lead to a condition known as chronic myeloid leukemia, which is characterised by the suppression of blood cell production, which can lead to a suppression in fighting infection, chronic pain and anemia in patients. A favoured option for treatment is a bone marrow transplant, which supplies the bone marrow with fully functioning stem cells as a combat option to treat the cancer, as well as with some chemotherapeutics. Busulfan is an orally active compound, which is widely used before a stem cell transplant, due to its very low cost and high efficacy when combined with a nitrogen mustard, such as Cyclophosphamide.

Multiple myeloma is a similar condition where over expression of myeloma stem cells lead to suppression in antibody production hindering the patient’s ability to fight infection, as well as being able to penetrate through to bone tissue, which can then cause the spread to other bone marrows in the body. Currently, there is little treatment regimens available apart from multiple stem cell transplants, which are costly and unfavourable for patients with many side effects, or no treatment is often indicated which decreases the patient’s lifespan.

A recent study in the Biology of Blood and Marrow Transplantation journal^[1] looked at the use of Busulfan, classified as an alkyl sulfonate, which interferes with DNA structure preventing cell replication, when combined with Bortezomib for relapsed multiple myeloma. Bortezomib is a proteasome inhibitor, which disrupts the cell cycle of cells, preventing cell division, apoptosis as well as inhibition of cytokines needed for cancerous progression. Both Busulfan and Bortezomib were analysed in order to determine their efficacy following a second Autologus stem cell transplant. This combination showed an appropriate toxicity level, as well as partial remission or an improvement in condition of 38 % of patients following their second transplant. Although extensive studies were assessed regarding optimal Busulfan therapy with a mean dose of 14.2 mg/kg, the research group suggest further investigative studies into higher doses of Bortezomib in order to assess whether a further improvement could be made.

Taj Accura Pharmaceuticals specialise in providing generic oncology products to an international portfolio, allowing for an overall reduction in health care costs while maintaining an increased quality of life for patients. Busulfan is available in 2 mg and 4 mg tablet dosage forms, while Bortezomib is available as a 3.5 mg vial for injection.

^[1] Freytes, C. O., Toro, J. J., Yeh, R. F., Stadtmauer, E. A., Ratanatharathorn, V., Akpek, G., … Reece, D. E.

(2014). Safety and efficacy of targeted-dose busulfan and bortezomib as a conditioning regimen for patients

with relapsed multiple myeloma undergoing a second autologous blood progenitor cell transplantation.

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow

Transplantation, 20(12), 1949–57.

BORTEZOMIB FOR INJECTION is used to treat multiple myeloma and mantle cell lymphoma

BORTEZOMIB FOR INJECTION is used to treat multiple myeloma and mantle cell lymphoma

BORTEZOMIB FOR INJECTION is used to treat multiple myeloma and mantle cell lymphoma