TY - JOUR
T1 - Treatment and outcome of newly diagnosed multiple myeloma patients > 75 years old
T2 - a retrospective analysis
AU - Al Saleh, Abdullah S.
AU - Visram, Alissa
AU - Parmar, Harsh
AU - Muchtar, Eli
AU - Buadi, Francis K.
AU - Dispenzieri, Angela
AU - Warsame, Rahma
AU - Lacy, Martha Q.
AU - Dingli, David
AU - Leung, Nelson
AU - Go, Ronald S.
AU - Gonsalves, Wilson I.
AU - Kourelis, Taxiarchis V.
AU - Hayman, Suzanne R.
AU - Kapoor, Prashant
AU - Gertz, Morie A.
AU - Kyle, Robert A.
AU - Rajkumar, S. Vincent
AU - Kumar, Shaji K.
N1 - Funding Information:
For continuous variables, the median and interquartile ranges (IQR) were described. The categorical variables were expressed as (n, %). The Chi-square test was used for comparing categorical variables and the Wilcoxon rank-sum test was used for continuous variables. Univariate analysis for PFS and OS using the Cox proportional hazards model was performed for the following variables: being on a triplet combination of an alkylator + PI + steroid, an IMiD + PI + dex, or an alkylator + IMiD + steroid vs. other therapy, revised international staging system (R-ISS) (stage 1–2 vs.3), bone marrow plasma cell percentage (BMPC%)(≥60% vs. <60%), receiving treatment during or after 2010 vs. before 2010, and trial vs. non-trial patients. The hazard ratio (HR) and 95% confidence interval (CI) were documented. Significant variables on the univariate analysis (defined by a P-value of ≤0.2) were included in the multivariate analysis. Statistical tests were two-sided and a P-value of <0.05 was considered significant. Statistical analysis was done using the JMP Pro software version 14.0 (SAS, Cary, NC). This project was made possible by the CTSA Grant UL1 TR002377 from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - This is a retrospective study of patients with multiple myeloma (MM) who were >75 years old. We identified 394 patients and for non-trial patients (n = 350), immunomodulatory drug (IMiD)+dex (32%) was the most commonly used regimen followed by alkylator with steroids or other therapy (21%), alkylator + proteasome inhibitor (PI)+steroid (18%), and IMiD + PI + dex (13%). Overall, achieving ≥ very good partial response was more in patients receiving a triplet compared to other therapies (46% vs. 21%, p < 0.0001). Also, the median overall survival (OS) was significantly longer in patients who were treated with a triplet (median OS: 50.2 vs. 32.8 months, p = 0.0006). In a multivariate for OS, receiving a triplet (HR: 0.65, p = 0.02), not having an R-ISS stage 3 (HR: 0.36, p = 0.0003), and bone marrow plasma cell percentage <60% (HR: 0.69, p = 0.03) were predictive. In conclusion, being able to receive triplet therapy was associated with better survival in our MM patients >75 years old.
AB - This is a retrospective study of patients with multiple myeloma (MM) who were >75 years old. We identified 394 patients and for non-trial patients (n = 350), immunomodulatory drug (IMiD)+dex (32%) was the most commonly used regimen followed by alkylator with steroids or other therapy (21%), alkylator + proteasome inhibitor (PI)+steroid (18%), and IMiD + PI + dex (13%). Overall, achieving ≥ very good partial response was more in patients receiving a triplet compared to other therapies (46% vs. 21%, p < 0.0001). Also, the median overall survival (OS) was significantly longer in patients who were treated with a triplet (median OS: 50.2 vs. 32.8 months, p = 0.0006). In a multivariate for OS, receiving a triplet (HR: 0.65, p = 0.02), not having an R-ISS stage 3 (HR: 0.36, p = 0.0003), and bone marrow plasma cell percentage <60% (HR: 0.69, p = 0.03) were predictive. In conclusion, being able to receive triplet therapy was associated with better survival in our MM patients >75 years old.
KW - Multiple myeloma
KW - elderly
KW - outcomes
KW - treatment
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U2 - 10.1080/10428194.2021.1950708
DO - 10.1080/10428194.2021.1950708
M3 - Article
C2 - 34263694
AN - SCOPUS:85110930483
SN - 1042-8194
VL - 62
SP - 3011
EP - 3018
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 12
ER -