| Summary: | Proteasome inhibitors, like bortezomib, play a key role in the treatment of multiple myeloma (MM); however, most patients eventually relapse and eventually show multiple drug resistance, and the molecular mechanisms of this resistance remain unclear. The aim of our study is to assess the expression of previously described genes that may influence the resistance to bortezomib treatment at the mRNA level (<i>ABCB1</i>, <i>CXCR4</i>, <i>MAF</i>, <i>MARCKS</i>, <i>POMP</i>, <i>PSMB5</i>, <i>RPL5</i>, <i>TXN,</i> and <i>XBP1</i>) and prognosis of MM patients. mRNA expression was determined in 73 MM patients treated with bortezomib-based regimens (30 bortzomib-sensitive and 43 bortezomib-refractory patients) and 11 healthy controls. <i>RPL5</i> was significantly down-regulated in multiple myeloma patients as compared with healthy controls. Moreover, POMP was significantly up-regulated in MM patients refractory to bortezomib-based treatment. In multivariate analysis, high expression of <i>PSMB5</i> and <i>CXCR</i> and autologous stem cell transplantation were independent predictors of progression-free survival, and high expression of <i>POMP</i> and <i>RPL5</i> was associated with shorter overall survival.
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