Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: analysis of 1175 patients

被引：234

作者：

Gay, Francesca ^{[1
]}

Larocca, Alessandra ^{[1
]}

Wijermans, Pierre ^{[2
]}

Cavallo, Federica ^{[1
]}

Rossi, Davide ^{[3
]}

Schaafsma, Ron ^{[4
]}

Genuardi, Mariella ^{[1
]}

Romano, Alessandra ^{[5
]}

Liberati, Anna Marina ^{[6
]}

Siniscalchi, Agostina ^{[7
]}

Petrucci, Maria T. ^{[8
]}

Nozzoli, Chiara ^{[9
]}

Patriarca, Francesca ^{[10
]}

Offidani, Massimo ^{[11
]}

Ria, Roberto ^{[12
]}

Omede, Paola ^{[1
]}

Bruno, Benedetto ^{[1
]}

Passera, Roberto ^{[13
]}

Musto, Pellegrino ^{[14
]}

Boccadoro, Mario ^{[1
]}

Sonneveld, Pieter ^{[15
]}

Palumbo, Antonio ^{[1
]}

机构：

[1] Univ Turin, Div Hematol, Myeloma Unit, AOU San Giovanni Battista, Turin, Italy

[2] Haga Hosp, The Hague, Netherlands

[3] Univ Piemonte Orientale Amedeo Avogadro, Dept Clin & Expt Med, Div Hematol, Novara, Italy

[4] MST Hosp, Enschede, Netherlands

[5] Univ Catania, Osped Ferrarotto, Div Hematol, Catania, Italy

[6] Univ Perugia, Dipartimento Med Clin & Sperimentale, Azienda Osped S Maria di Terni, I-06100 Perugia, Italy

[7] Univ Roma Tor Vergata, S Eugenio Hosp, Dept Hematol, Rome, Italy

[8] Univ Roma La Sapienza, Rome, Italy

[9] Careggi Hosp Florence, Hematol Unit, Florence, Italy

[10] Azienda Osped Univ Udine, Clin Ematol, Udine, Italy

[11] Azienda Osped Univ Osped Riuniti Ancona, Clin Ematol, Ancona, Italy

[12] Univ Bari Aldo Moro, Dipartimento Sci Biomed & Oncol Umana, Sez Med Interna & Oncol, Clin Policlin, Bari, Italy

[13] Univ Turin, Div Med Nucl 2, AOU S Giovanni Battista, Turin, Italy

[14] Ctr Riferimento Oncol Basilicata, Ist Ricovero & Cura Carattere Sci, Dept Oncohematol, Rionero In Vulture, Italy

[15] Erasmus MC, Rotterdam, Netherlands

来源：

BLOOD | 2011年 / 117卷 / 11期

关键词：

DIAGNOSED MULTIPLE-MYELOMA; INTERNATIONAL STAGING SYSTEM; PREDNISONE PLUS THALIDOMIDE; MELPHALAN-PREDNISONE; INITIAL TREATMENT; ORAL MELPHALAN; BORTEZOMIB; DEXAMETHASONE; EFFICACY; SUPERIOR;

D O I：

10.1182/blood-2010-09-307645

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Complete response (CR) was an uncommon event in elderly myeloma patients until novel agents were combined with standard oral melphalan-prednisone. This analysis assesses the impact of treatment response on progression-free survival (PFS) and overall survival (OS). We retrospectively analyzed 1175 newly diagnosed myeloma patients, enrolled in 3 multicenter trials, treated with melphalanprednisone alone (n = 332), melphalan-prednisone- thalidomide (n = 332), melphalan-prednisone-bortezomib (n = 257), or melphalan-prednisone-bortezomib-thalidomide (n = 254). After a median follow-up of 29 months, the 3-year PFS andOSwere 67% and 27% (hazard ratio = 0.16; P < .001), and 91% and 70% (hazard ratio = 0.15; P < .001) in patients who obtained CR and in those who achieved very good partial response, respectively. Similar results were observed in patients older than 75 years. Multivariate analysis confirmed that the achievement of CR was an independent predictor of longer PFS and OS, regardless of age, International Staging System stage, and treatment. These findings highlight a significant association between the achievement of CR and long-term outcome, and support the use of novel agents to achieve maximal response in elderly patients, including those more than 75 years. This trial was registered at www.clinicaltrials.gov as #NCT00232934, #ISRCTN 90692740, and #NCT01063179. (Blood. 2011; 117(11): 3025-3031)

引用

页码：3025 / 3031

页数：7

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