Association of Thrombocytopenia With Disease Burden, High-Risk Cytogenetics, and Survival in Newly Diagnosed Multiple Myeloma Patients Treated With Novel Therapies.

Autor: Charalampous C; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Goel U; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Kapoor P; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Binder M; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Buadi F; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Dingli D; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Dispenzieri A; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Fonder A; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Gertz M; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Gonsalves W; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Hayman S; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Hobbs M; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Hwa YL; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Kourelis T; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Lacy M; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Leung N; Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN., Lin Y; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Warsame R; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Kyle RA; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Rajkumar V; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN., Kumar SK; Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN. Electronic address: kumar.shaji@mayo.edu.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2024 Oct; Vol. 24 (10), pp. e329-e335. Date of Electronic Publication: 2024 Jun 01.
DOI: 10.1016/j.clml.2024.05.020
Abstrakt: Background: The effect of thrombocytopenia has not been studied in the era of novel treatments in multiple myeloma (MM).
Objective: To evaluate the clinical characteristics and outcomes in MM patients presenting with thrombocytopenia.
Materials: Newly diagnosed MM patients between 2008 and 2018 who received at least 2 novel agents at induction. Thrombocytopenia was defined as a platelet count of less than < 150,000/mm 3 .
Results: A total of 648 patients were identified. Thrombocytopenia was found in 120 patients (18.5%). Baseline disease characteristics associated with higher rates of thrombocytopenia at baseline included IgA myeloma, P < .01, ISS 3 versus 1 or 2, P < .01, R-ISS 3 versus 1 or 2, P < .01, renal failure (CrCl < 30 mL/min), P < .01, hypercalcemia (Ca > 11.5 mg/dL), P < .01, elevated LDH, P < .03, anemia (Hb < 10 g/dL), P < .01, higher serum monoclonal protein, P < .02, and > 60% plasma cells in the bone marrow, P < .01. Thrombocytopenia was more prevalent across patients with t(4;14) and t(14;16), but was not associated with an overall high-risk fluorescence in situ hybridization (FISH) classification. Median OS was significantly lower among patients with thrombocytopenia (64.4 vs. 145.0 months, P < .01). In multivariable Cox regression, thrombocytopenia was associated with mortality (HR = 2.45, 95% CI, 1.7-3.6) independently of age, sex, high-risk FISH, ISS stage, response at induction, percentage of plasma cells in the BM, and anemia.
Conclusion: We found that thrombocytopenia was seen among one-fifth of MM patients and was more common in patients with (t[4; 14] and t[14; 16]). Thrombocytopenia had an independent association with worse survival.
Competing Interests: Disclosure The authors have stated that they have no conflicts of interest.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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