Cyclophosphamide, Thalidomide, and Dexamethasone as Initial Therapy for Patients With Newly Diagnosed Multiple Myeloma in a Middle-Income Country: 7-Year Follow-Up
Autor: | Marco Villena, Tatiana Vidaurre, Shirley Quintana, Fernando Valencia, Karina Aliaga, Luis Casanova, Rossana Ruiz, Jule Vasquez |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
Cancer Research 2019-20 coronavirus outbreak Pediatrics medicine.medical_specialty Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Hematologic Malignancies Newly diagnosed Middle income country Dexamethasone Bortezomib 03 medical and health sciences 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Initial therapy Cyclophosphamide Multiple myeloma Aged Retrospective Studies business.industry Cyclophosphamide/Thalidomide ORIGINAL REPORTS Middle Aged medicine.disease Thalidomide Oncology 030220 oncology & carcinogenesis business Multiple Myeloma 030215 immunology medicine.drug Follow-Up Studies |
Zdroj: | JCO Global Oncology |
ISSN: | 2687-8941 |
Popis: | PURPOSE Major progress has occurred in multiple myeloma (MM) treatment in recent years, but this is not seen in low- and middle-income countries. MATERIALS AND METHODS We retrospectively assessed the efficacy and safety of cyclophosphamide, thalidomide, and dexamethasone (cyclophosphamide 400 mg/m2 for 5 days, thalidomide 100 mg once daily, if tolerated, and dexamethasone 40 mg once weekly; in 28-day cycles) in patients with newly diagnosed MM treated at our institution between April 2008 and December 2012. Survival outcomes were estimated by the Kaplan-Meier method. RESULTS Fifty-nine patients were found to meet the selection criteria. Median age was 56 years (27-78). Fifty-nine percent (n = 35) were male. International Staging System three was found in 24%. The median number of treatment cycles was 11 (range 4-12). After a median of 81-month follow-up (range 5-138 months), the overall response rate was 69.5%. The complete response and very good partial response were 5% and 32%, respectively. Median progression-free survival (PFS) was 35 months (95% CI, 18 to 41). The 3-year PFS was 47.4% (95% CI, 34.5 to 59.6) and 5-year PFS was 24.9% (95% CI, 14.4 to 36.9). The median of overall survival (OS) was 81 months (95% CI, 33 to not reached). The 3-year OS was 63.4% (95% CI, 49.2 to 74.6), and 5-year OS was 57.5% (95% CI, 43.2 to 69.4). The most common adverse event was neutropenia (grade 3 and 4, 30.5%). Out of 23 patients eligible for stem-cell transplantation, 10 (43.5%) proceeded with autologous transplantation. Treatment-related deaths occurred in four patients (6.7%). CONCLUSION Cyclophosphamide, thalidomide, and dexamethasone achieves good response rates with tolerable toxicity, especially in patients age 65 years or younger representing a feasible approach for patients with MM in low-income health care settings. |
Databáze: | OpenAIRE |
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