Haematologica 2004;89: supplement no. 6 - Supplements ...

112PostersPosterMULTIPLE MYELOMA IIPO-082CURRENT ISSUES IN TOTAL BODY SCINTIGRAPHY WITHSESTAMIBI IN MULTIPLE MYELOMAPizzuti M, Fe A,* Attolico I, Filardi N, Vertone D,Mussolin l,* Nappi A,* Schiavariello S,* Martino L,*Ricciuti FU. O. di Ematologia, Ospedale San Carlo, Potenza; *U.O. di Medicina Nucleare, Ospedale San Carlo, Potenza,ItalyTotal Body scintigraphy with Technetium-99m Sestamibi(Mibi) has been used for many years to evaluatethe bone lesions of patients with MultipleMyeloma (MM) and since the early trials it has beencompared with skeletal radiology. We have evaluated58 patients with MM. Mibi scintigraphy was positive(score >2) in 44 patients, with a pattern ofuptake diffuse (D) in 32, focal (F) in 2, diffuse + focal(D+F) in 10.The score correlated with stage, plasmacells invasion and monoclonal protein. Mibi scintigraphywas positive more often than skeletal X-ray,but not all the bone lesions showed by X-Ray correspondto zones of higher Mibi uptake. Comparison toMagnetic Resonance Imaging (MRI) showed that adiffuse uptake pattern did not always correspond toosteolytic areas. This is due to the fact that Mibiscintigraphy is based on cell metabolism whereas theother imaging methods account for structural lesions.Moreover, Mibi did not prove effective in identifyingsmall lesions ( 4 had an aggressive disease(resistance to treatment, early relapse). The role ofscintigraphy with Sestamibi in follow up is betterdefined. The average score of our patients respondingto treatment decreases from 4.2 to 2.8.In resistantpatients it does not change. After relapse it goesback to the levels measured at diagnosis. This correlationis particularly useful in not secreting MM. Weguess a correlation between a fast wash out of Mibifrom neoplastic plasma cells and expression ofP170.In 12 patients with score > 4 we performed asecond scan after 2 hours, comparing the score on thecervical dorsal spine and normalizing by the half lifeof Mibi. In 8 cases the wash out was >50%. It is tooearly to draw conclusions on these preliminaryresults. 5 of the 8 patients with a fast wash out havebeen treated with Thalidomide and 4 of themobtained a good response. We might guess thatThalidomide activity is not influenced by the excretionmechanisms of the cells, linked to P170 expression,that cause the premature wash out of Mibi. Thescintigraphy with Mibi can support conventionalimaging methods to provide indications for prognosisand response to therapy in patients with MM. Afast wash out of Mibi could correlate with resistanceto chemotherapy but not with response to Thalidomide.Total Body scintigraphy with Technetium-99mSestamibi (Mibi) has been used for many years toevaluate the bone lesions of patients with MultipleMyeloma (MM) and since the early trials it has beencompared with skeletal radiology. We have evaluated58 patients with MM. Mibi scintigraphy was positive(score >2) in 44 patients, with a pattern ofuptake diffuse (D) in 32, focal (F) in 2, diffuse + focal(D+F) in 10.The score correlated with stage, plasmacells invasion and monoclonal protein. Mibi scintigraphywas positive more often than skeletal X-ray,but not all the bone lesions showed by X-Ray correspondto zones of higher Mibi uptake. Comparison toMagnetic Resonance Imaging (MRI) showed that adiffuse uptakePO-083BORTEZOMIB (VELCADE) AS SALVAGE THERAPY FORADVANCED MULTIPLE MYELOMA: A MULTICENTRE SURVEY OFITALIAN PATIENTS TREATEDOUTSIDE OF CLINICAL TRIALSMusto P, Cascavilla N, Spriano M,* Zambello R,°°Guglielmelli T,^ Catalano L,** Balleari E,° Falcone A,Sanpaolo G, Bodenizza C, La Sala A, Mantuano S,Scalzulli P, Nobile M, Dell'Olio M, Melillo L, GrecoM, Beltrami G, Carella AM Jr, Carella AM*Hematology and Stem Cell Transplantation, IRCCS"Casa Sollievo della Sofferenza", S. Giovanni Rotondo;Hematology* and DIMI,° S. Martino Hospital,Genova; Clinical and Experimental Medicine, Universityof Padova;°° Hematology, S. Luigi GonzagaHospital, Orbassano;^ Chair of Hematology, FedericoII University, Napoli*, Italy*Bortezomib (VELCADE, formerly PS-341, Millennium)is a novel first-class agent that inhibits the proteasome,a multicatalytic cellular enzyme whoseactivity entails several molecular mechanisms,including, in particular, the NF-κB pathway. Recentphase I-II clinical trials have demonstrated the efficayhaematologica vol. 89[suppl. n. 6]:september 2004