Real-World Risk of Severe Cytopenias in Multiple Myeloma Patients Sequentially Treated with Immunomodulatory Drugs

被引:1
作者
Barberio, Julie [1 ,2 ]
Lash, Timothy L. [1 ]
Nooka, Ajay K. [3 ]
Naimi, Ashley I. [1 ]
Patzer, Rachel E. [1 ,4 ]
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
关键词
Multiple myeloma; Cytopenia; Neutropenia; Immunomodulatory drugs; LENALIDOMIDE; NEUTROPENIA; MATURATION; PU.1;
D O I
10.1159/000539127
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页数:12
相关论文
共 50 条
  • [21] Bortezomib therapy in a real-world setting in patients with relapsed or refractory multiple myeloma
    Huang, Shang-Yi
    Chen, Tsai-Yun
    Kuo, Ching-Yuan
    Chen, Yeu-Chin
    Lin, Sheng-Fung
    Chang, Ming-Chih
    Lv, Xinzhu
    Yang, Betty
    Chang, Cheng-Shyong
    ONCOLOGY REVIEWS, 2019, 13 (01) : 15 - 22
  • [22] Real-World Cytogenetic Testing Among Patients with Multiple Myeloma in the United States
    Rice, Megan
    Hao, Lichen
    Singh, Erin
    CLINICAL LYMPHOMA MYELOMA & LEUKEMIA, 2020, 20 : S297 - S297
  • [23] Thrombotic events in patients with Myeloma treated with Immunomodulatory drugs; Results of the Myeloma XI Study
    Bradbury, C. A.
    Jenner, M.
    Striha, A.
    Cook, G.
    Pawlyn, C.
    Jones, J.
    Cairns, D.
    Hockaday, A.
    Paterson, A.
    Drayson, M.
    Owen, R.
    Kaiser, M.
    Gregory, W.
    Davis, F.
    Morgan, G.
    Jackson, G.
    BRITISH JOURNAL OF HAEMATOLOGY, 2018, 181 : 19 - 20
  • [24] The applicability of the Second Revision of the International Staging System for patients with multiple myeloma receiving immunomodulatory drugs or proteasome inhibitor-based regimens as induction treatment: A real-world analysis
    Chen, Haimin
    Zhou, Nian
    Hu, Xiaohua
    Wang, Dongjiao
    Wei, Wei
    Peng, Rong
    Chen, Xiaoling
    Shi, Haotian
    Wu, Lixia
    Yu, Wenjun
    Zhao, Wenhao
    Zhou, Fan
    HEMATOLOGICAL ONCOLOGY, 2023, 41 (01) : 139 - 146
  • [25] Real-world incidence and risk factors of bortezomib-related cardiovascular adverse events in patients with multiple myeloma
    Jang, Bitna
    Jeong, Jonghyun
    Heo, Kyu-Nam
    Koh, Youngil
    Lee, Ju-Yeun
    BLOOD RESEARCH, 2024, 59 (01)
  • [26] Venous Thromboembolism in Patients With Myeloma: Incidence and Risk Factors in a "Real-World" Population
    Crowley, Maeve P.
    Eustace, Joseph A.
    O'Shea, Susan I.
    Gilligan, Oonagh M.
    CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, 2014, 20 (06) : 600 - 606
  • [27] It's the Response That Matters: Real-World Data of Multiple Myeloma Patients Treated without Upfront Stem Cell Transplant
    Lavu, Rohit Reddy
    Kumar, Lalit
    Velagapudi, Raja Mounika
    Konda, Sreenivas
    Arora, Shalabh
    CLINICAL LYMPHOMA MYELOMA & LEUKEMIA, 2021, 21 : S433 - S433
  • [28] Renal response in real-world carfilzomib- vs bortezomib-treated patients with relapsed or refractory multiple myeloma
    Kumar, Shaji
    Fu, Alan
    Niesvizky, Ruben
    Jagannath, Sundar
    Boccia, Ralph
    Raje, Noopur
    BLOOD ADVANCES, 2021, 5 (02) : 367 - 376
  • [29] Real-world toxicity and effectiveness of ixazomib, lenalidomide, and dexamethasone in Korean patients with relapsed and/or refractory multiple myeloma
    Ji Hyun Lee
    Sung-Hyun Kim
    Hye Ryeon Kim
    Chang-Ki Min
    Je-Jung Lee
    Ho-Jin Shin
    Jae-Cheol Jo
    Ji Yun Lee
    Joon Ho Moon
    Kihyun Kim
    International Journal of Hematology, 2023, 117 : 225 - 235
  • [30] Real-world data on the efficacy and safety of daratumumab treatment in Hungarian relapsed/refractory multiple myeloma patients
    Lovas, Szilvia
    Varga, Gergely
    Farkas, Peter
    Masszi, Tamas
    Wohner, Nikolett
    Bereczki, Agnes
    Adamkovich, Nora
    Borbenyi, Zita
    Szomor, Arpad
    Alizadeh, Hussain
    Szaleczky, Erika
    Wolf, Krisztina
    Schneider, Tamas
    Plander, Mark
    Szendrei, Tamas
    Csacsovszki, Otto
    Csukly, Zoltan
    Rajnics, Peter
    Egyed, Miklos
    Nagy, Zsolt
    Rejto, Laszlo
    Illes, Arpad
    Mikala, Gabor
    Varoczy, Laszlo
    INTERNATIONAL JOURNAL OF HEMATOLOGY, 2019, 110 (05) : 559 - 565