Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone

被引：4

作者：

Lee, Ho Sup ^{[1
]}

Kim, Kihyun ^{[2
]}

Lee, Je-Jung ^{[3
]}

Yoon, Sung-Soo ^{[4
]}

Bang, Soo-Mee ^{[5
]}

Kim, Jin Seok ^{[6
]}

Eom, Hyeon-Seok ^{[7
]}

Yoon, Dok Hyun ^{[8
]}

Lee, Yoojin ^{[9
,12
]}

Shin, Ho-Jin ^{[10
]}

Park, Yong ^{[11
]}

Jo, Jae-Cheol ^{[12
]}

Lee, Won Sik ^{[13
]}

Do, Young Rok ^{[14
]}

Mun, Yeung-Chul ^{[15
]}

Lee, Mark Hong ^{[16
]}

Kim, Hyo Jung ^{[17
]}

Kim, Sung-Hyun ^{[18
]}

Kim, Min Kyoung ^{[19
]}

Lim, Sung-Nam ^{[20
]}

Park, Seong Kyu ^{[21
]}

Yi, Jun Ho ^{[22
]}

Lee, Jae Hoon ^{[23
]}

Min, Chang-Ki ^{[24
]}

机构：

[1] Kosin Univ, Dept Internal Med, Coll Med, Busan, South Korea

[2] Sungkyunkwan Univ, Dept Med, Samsung Med Ctr, Sch Med, Seoul, South Korea

[3] Chonnam Natl Univ, Hwasun Hosp, Dept Hematol Oncol, Hwasun, Jeollanamdo, South Korea

[4] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea

[5] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seongnam, South Korea

[6] Yonsei Univ, Coll Med, Div Hematol, Dept Internal Med,Severance Hosp, Seoul, South Korea

[7] Natl Canc Ctr Korea, Dept Internal Med, Goyang, South Korea

[8] Univ Ulsan, Dept Oncol, Asan Med Ctr, Coll Med, Seoul, South Korea

[9] Kyungpook Natl Univ Hosp, Dept Hematol Oncol, Daegu, South Korea

[10] Pusan Natl Univ Hosp, Dept Internal Med, Busan, South Korea

[11] Korea Univ, Dept Internal Med, Coll Med, Seoul, South Korea

[12] Univ Ulsan, Coll Med, Dept Hematol & Oncol, Ulsan Univ Hosp, Ulsan, South Korea

[13] Busan Paik Hosp, Dept Internal Med, Busan, South Korea

[14] Keimyung Univ, Dept Hematooncol, Dongsan Med Ctr, Daegu, South Korea

[15] Ewha Womans Univ, Dept Internal Med, Sch Med, Seoul, South Korea

[16] Konkuk Univ, Sch Med, Med Ctr, Div Hematol Oncol,Dept Internal Med, Seoul, South Korea

[17] Hallym Univ, Coll Med, Dept Internal Med, Sacred Heart Hosp, Anyang, South Korea

[18] Dong A Univ, Dept Internal Med, Dong A Med Ctr, Coll Med, Busan, South Korea

[19] Yeungnam Univ, Dept Med, Coll Med, Daegu, South Korea

[20] Haeundae Baek Hosp, Dept Internal Med, Busan, South Korea

[21] Soonchunhyang Univ, Bucheon Hosp, Dept Hematol Oncol, Bucheon, South Korea

[22] Chung Ang Univ, Div Hematol Oncol, Dept Med, Seoul, South Korea

[23] Gachon Univ, Dept Internal Med, Gil Hosp, Incheon, South Korea

[24] Catholic Univ Korea, Seoul St Marys Hosp, Dept Internal Med, 505 Banpo Dong, Seoul 137701, South Korea

来源：

INTERNATIONAL JOURNAL OF HEMATOLOGY | 2021年 / 113卷 / 01期

关键词：

Elderly multiple myeloma; Relapsed and refractory; Lenalidomide and dexamethasone; Frailty; Survival; GERIATRIC ASSESSMENT; CONSENSUS; SURVIVAL; THERAPY;

D O I：

10.1007/s12185-020-02988-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We compared efficacy and safety, according to frailty, of elderly patients with relapsed and refractory multiple myeloma (RRMM) treated with lenalidomide and dexamethasone (Rd), for whom bortezomib treatment had failed. Patients, 164 (52.9%) and 146 (47.1%), were classified as non-frail and frail using a simplified frailty scale. The overall response rates (ORR) and survival outcomes were lower in frail than in non-frail patients (ORR: 56.2% vs. 67.7%,P = 0.069; median progression free survival: 13.17 vs. 17.80 months,P = 0.033; median overall survival: 23.00 vs. 36.27 months,P = 0.002, respectively). The number of treatment emergent adverse events in grade 3 or worse was higher in frail than in non-frail patients (41.8% vs. 24.4%,P = 0.002, respectively). In frail patients, independent poor prognostic factors for survival were two or more Charlson comorbidity index (CCI) score, prior to exposure to both bortezomib and thalidomide, and achieved less than partial response In conclusion, frailty could predict clinical outcomes of Rd treatment in elderly patients with RRMM who had failed prior bortezomib. In frail patients, lower CCI in addition to less previous treatment exposure and deep response were associated with better survival.

引用

页码：81 / 91

页数：11

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