The role of novel agents on the reversibility of renal impairment in newly diagnosed symptomatic patients with multiple myeloma
| Autor: | E. Terpos, Despoina Mparmparoussi, Maria Roussou, M Spyropoulou-Vlachou, Meletios A. Dimopoulos, Maria Gkotzamanidou, Charis Matsouka, Nikitas Nikitas, Erasmia Psimenou, Efstathios Kastritis |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Urology Renal function Dexamethasone Bortezomib hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols medicine Humans Renal Insufficiency Survival rate Lenalidomide Melphalan Multiple myeloma Aged Aged 80 and over business.industry Hematology Middle Aged medicine.disease Prognosis Boronic Acids Surgery Thalidomide Survival Rate Regimen Oncology Doxorubicin Vincristine Pyrazines Prednisone Female business Multiple Myeloma medicine.drug Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Leukemia. 27(2) |
| ISSN: | 1476-5551 |
| Popis: | The role of thalidomide, bortezomib and lenalidomide in multiple myeloma patients presenting with renal impairment was evaluated in 133 consecutive newly diagnosed patients who were treated with a novel agent-based regimen. A significant improvement of renal function (renalPR (renal partial response)) was observed in 77% of patients treated with bortezomib, in 55% with thalidomide and in 43% with lenalidomide (P=0.011). In multivariate analysis, bortezomib-based therapy was independently associated with a higher probability of renal response compared with thalidomide- or lenalidomide-based therapy. Other important variables included eGFR (estimated glomerular filtration rate) ≥30 ml/min, age ≤65 years and myeloma response. Patients treated with bortezomib achieved at least renalPR in a median of 1.34 months vs 2.7 months for thalidomide and >6 months for lenalidomide-treated patients (P=0.028). In multivariate analysis bortezomib-based therapy, higher doses of dexamethasone (≥160 mg during the first month of treatment), an eGFR ≥30 ml/min and age ≤65 years were independently associated with shorter time to renal response. In conclusion, bortezomib-based therapies may be more appropriate for the initial management of patients with myeloma-related renal failure; however, thalidomide and lenalidomide are also associated with significant probability of improvement of their renal function. |
| Databáze: | OpenAIRE |
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