[Bortezomib in multiple myeloma patients after allogeneic stem cell transplantation]

Bortezomib represents a novel biological and targeted treatment modality with excellent treatment results in multiple myeloma patients. Bortezomib has also been successfully used several times in heavily pre-treated patients with myeloma relapse or progression after allogeneic stem cell transplantation. Its immunomodulatory effect, mediated, for instance, through the selective apoptosis of alloreactive T-lymphocytes and inhibition of the nuclear factor kappa B, brings the potential of graft versus host disease management, while the immunological anti-tumour effect remains preserved. Apart from thrombocytopenia, neurotoxicity most likely potentiated by concomitant and long-term use of cyclosporine is the major side effect of the treatment. The impact and modulation of graft versus host disease remains controversial in clinical practice. Bortezomib is effective and feasible in the post-transplant setting.