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We evaluated panobinostat\u2010induced post\u2010transplant responses and identified correlative biomarkers in patients with multiple myeloma who had failed to achieve a complete response after autologous transplantation. Patients received panobinostat 45\u00a0mg administered three\u2010times weekly (TIW) on alternate weeks of 28\u2010day cycles commencing 8\u201312\u00a0weeks post\u2010transplant. Twelve of 25 patients (48%) improved their depth of response after a median (range) of 4\u00b73\u00a0(1\u00b79\u20139\u00b77)\u00a0months of panobinostat. In responders, T\u2010lymphocyte histone acetylation increased after both three cycles (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b705) and six cycles (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701) of panobinostat when compared to baseline, with no differences in non\u2010responders. The reduction in the proportion of CD127<jats:sup>+<\/jats:sup>CD8<jats:sup>+<\/jats:sup> T cells and CD4:CD8 ratio was significantly greater, after three and six cycles of panobinostat compared to pre\u2010transplant, in non\u2010responders when compared to responders. Whole marrow RNA\u2010seq revealed widespread transcriptional changes only in responders with baseline differences in genes involved in ribosome biogenesis, oxidative phosphorylation and metabolic pathways. This study confirmed the efficacy of panobinostat as a single agent in multiple myeloma and established acetylation of lymphocyte histones, modulation of immune subsets and transcriptional changes as pharmacodynamic biomarkers of clinical benefit.<\/jats:p>","DOI":"10.1111\/bjh.17080","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T11:59:20Z","timestamp":1600430360000},"page":"160-170","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Phase II trial of single\u2010agent panobinostat consolidation improves responses after sub\u2010optimal transplant outcomes in multiple myeloma"],"prefix":"10.1111","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1034-5179","authenticated-orcid":false,"given":"Sridurga","family":"Mithraprabhu","sequence":"first","affiliation":[{"name":"Myeloma Research Group Australian Centre for Blood Diseases Alfred Hospital\u2010Monash 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\u2013 Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Spencer","sequence":"additional","affiliation":[{"name":"Myeloma Research Group Australian Centre for Blood Diseases Alfred Hospital\u2010Monash University Melbourne Victoria Australia"},{"name":"Malignant Haematology and Stem Cell Transplantation Alfred Hospital Melbourne Victoria Australia"},{"name":"Department of Clinical Haematology Monash University Clayton Victoria 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