Clinical features and survival of 338 multiple myeloma patients treated with hematopoietic stem cell transplantation or conventional chemotherapy.

Autor: Pérez R; Hospital Universitario Virgen de Arrixaca, Murcia, Spain., Durán MS; Hospital Universitario Ciudad de Jaén, Jaén, Spain., Mayans J; Hospital Arnau de Vilanova, Valencia, Spain., Soler A; Hospital Parc Tauli, Sabadell, Spain., Castillo I; Hospital General Universitario de Elda, Alicante, Spain., Jurado M; Hospital Virgen de las Nieves, Granada, Spain., Ribas P; Hematology, Hospital Dr. Peset, Valencia, Spain., Menchaca Echevarria MC; Hospital Txagorritxu, Vitoria, Spain., Hernandez MT; Servicio de Hematología Clínica, Hospital Universitario de Canarias, Tenerife, Spain., Lopez Garcia-Carreño MD; Hospital Santa Maria del Rosell, Cartagena, Spain., Echeveste Gutierrez A; Hospital de Donostia, San Sebastián, Spain., Bailen Garcia A; Hospital de Antequera, Málaga, Spain., Lopez S; Celgene SL, Madrid, Spain., Baquero J; Celgene SL, Madrid, Spain., Ramirez G; H.U. Virgen de la Victoria, Málaga, Spain.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2016 Apr; Vol. 96 (4), pp. 417-24. Date of Electronic Publication: 2015 Nov 01.
DOI: 10.1111/ejh.12611
Abstrakt: Therapeutic approaches against multiple myeloma (MM) have largely changed during the past decade. Hematopoietic stem cell transplantation (HSCT) and licensing of immunomodulators and proteasome inhibitors have resulted in better response and increased overall survival rates compared to previous conventional therapies. To assess the impact that these new strategies have had on outcome of patients with symptomatic MM in Spain, we conducted an epidemiological retrospective analysis of 338 newly diagnosed patients with stage II-III MM who started first-line treatment over a 2-yr period (2003-2005) by collecting data from their medical records. Most patients had been diagnosed with secretory MM (94.4%), 41.7% stage II and 58.3% stage III. The presence of bone lesions (72.2%), as well as anemia (79.8%) and elevated beta2-microglobulin levels (62.3%), was a common finding; in contrast, hypercalcemia and elevated serum creatinine were less frequent (25% each). First-line treatment had consisted of either conventional chemotherapy (62%) or induction treatment plus autologous HSCT (38%), as per standard clinical practice. HSCT not only resulted in greater objective response rates (93% vs. 50%), but also contributed to a significant increase in 3-yr survival (85% vs. 49.7%; 95% CI, range 77-91 vs. 41-58; P < 0.001). Overall, 55% of patients presented treatment-related adverse events, mainly hematological. Toxicity rates were higher among patients treated with alkylating-based regimens and in those undergoing transplantation. In conclusion, data analysis shows an adequate balance between increased response rates and safety that supports the use of up-front high-dose HSCT therapy in younger patients. Most importantly, this study provides further confirmation that the introduction of HSCT has significantly prolonged survival of patients with MM.
(© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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