Real-World Risk of Severe Cytopenias in Multiple Myeloma Patients Sequentially Treated with Immunomodulatory Drugs
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作者:
Barberio, Julie
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Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Amgen Inc, Ctr Observat Res, Thousand Oaks, CA 91320 USAEmory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Barberio, Julie
[1
,2
]
Lash, Timothy L.
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Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USAEmory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Lash, Timothy L.
[1
]
Nooka, Ajay K.
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Emory Univ, Winship Canc Inst, Sch Med, Atlanta, GA USAEmory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Nooka, Ajay K.
[3
]
Naimi, Ashley I.
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Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USAEmory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Naimi, Ashley I.
[1
]
Patzer, Rachel E.
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Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Regenstrief Inst Hlth Care, Indianapolis, IN USAEmory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Patzer, Rachel E.
[1
,4
]
Kim, Christopher
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Amgen Inc, Ctr Observat Res, Thousand Oaks, CA 91320 USAEmory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
Kim, Christopher
[2
]
机构:
[1] Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA
[2] Amgen Inc, Ctr Observat Res, Thousand Oaks, CA 91320 USA
[3] Emory Univ, Winship Canc Inst, Sch Med, Atlanta, GA USA
[4] Regenstrief Inst Hlth Care, Indianapolis, IN USA
Introduction: Most multiple myeloma (MM) patients experience cytopenias, likely driven by both disease and treatment-related factors. Immunomodulatory agents (IMiDs), which form the backbone of most anti-myeloma regimens, are known to cause higher grade cytopenias. In this context, the impact of sequential IMiD treatments on cytopenia risk is unknown. Methods: We evaluated the cumulative risks of severe cytopenias following second line of therapy (LOT) initiation in 5,573 MM patients in the Flatiron Health database. Patients for whom both LOTs 1 and 2 contained IMiDs were considered "sequentially exposed"; those for whom neither contained IMiDs were "never exposed." Results: For the neutropenia outcome, compared to the never exposed, the sequentially exposed had the highest 1-year risk (risk difference [RD] 12%), followed by those only recently exposed during LOT 2 (RD 8%), then by those with only past exposure during LOT 1 (RD 5%). A similar pattern was observed for leukopenia, but no meaningful differences were observed for anemia or thrombocytopenia. The associations between sequential exposure, versus never, with neutropenia and leukopenia were even stronger among those with a recent cytopenia history. Conclusion: Results suggest that sequential exposure to IMiDs is a risk factor for higher grade cytopenias. These findings have profound clinical implications in choosing newer LOTs with potential risks of cytopenia.
机构:
Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ Hosp, Dept Pharm, Seoul 03080, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Jang, Bitna
Jeong, Jonghyun
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Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Jeong, Jonghyun
Heo, Kyu-Nam
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Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Heo, Kyu-Nam
Koh, Youngil
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Seoul Natl Univ Hosp, Dept Internal Med, 101 Daehakro, Seoul 110744, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Koh, Youngil
Lee, Ju-Yeun
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Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
机构:
Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ Hosp, Dept Pharm, Seoul 03080, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Jang, Bitna
Jeong, Jonghyun
论文数: 0引用数: 0
h-index: 0
机构:
Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Jeong, Jonghyun
Heo, Kyu-Nam
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机构:
Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Heo, Kyu-Nam
Koh, Youngil
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h-index: 0
机构:
Seoul Natl Univ Hosp, Dept Internal Med, 101 Daehakro, Seoul 110744, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Koh, Youngil
Lee, Ju-Yeun
论文数: 0引用数: 0
h-index: 0
机构:
Seoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea
Seoul Natl Univ, Res Inst Pharmaceut Sci, 1 Gwanak Ro, Seoul 08826, South KoreaSeoul Natl Univ, Coll Pharm, 1 Gwanak Ro, Seoul 08826, South Korea