Τίτλος:
Real-world data on incidence, clinical characteristics and outcome of patients with macrofocal multiple myeloma (MFMM) in the era of novel therapies: A study of the Greco-Israeli collaborative myeloma working group
Περίληψη:
We investigated incidence, characteristics and outcome of patients with macrofocal multiple myeloma (MFMM) treated mainly with novel therapies. Based on definition (BMPCs <20% and lytic lesions/plasmacytomas, without anemia, renal insufficiency or hypercalcemia) we identified 140 patients with MFMM, among 4650 myeloma patients (3%). Twice the number of patients with typical myeloma were used as controls; 60% were <65 years and 70% had advanced bone disease. Plasmacytomas were more frequent in MFMM compared with standard myeloma (68% vs 15%, P <.05). Adverse prognostic parameters (high lactate dehydrogenase, advanced stage, high risk cytogenetics, immunoparesis) were less common in patients with MFMM compared with controls (P <.05); 90% received novel agents and 47% underwent autologous transplantation upfront; 90% achieved an objective response; 70% had at least very good partial response which was significantly higher compared with controls (P <.05). After a median follow-up of 52 months, 33 patients have died. Early death (<12 months) was infrequent in MFMM. Median progression-free survival and overall survival (OS) were 46 and 129 months respectively, both significantly longer compared with controls (P <.001). Proteasome inhibitor (PI)-based therapy was the only independent predictor for OS in the multivariate analysis (HR: 3.9; P <.001). In conclusion, MFMM is a distinct entity presented in young and elderly subjects, characterized by limited bone marrow infiltration, advanced bone disease and frequent presence of plasmacytomas; MFMM patients have less often adverse prognostic features and achieve excellent responses and prolonged OS especially when treated with PI-based therapies. Novel imaging will help in a more accurate classification of this entity. © 2020 Wiley Periodicals, Inc.
Συγγραφείς:
Katodritou, E.
Kastritis, E.
Gatt, M.
Cohen, Y.C.
Avivi, I.
Pouli, A.
Lalayianni, C.
Lavi, N.
Delimpasis, S.
Kyrtsonis, M.-C.
Michael, M.
Suriu, C.
Miri, Z.
Tzafarti, K.
Vadikoliou, C.
Maltezas, D.
Zikos, P.
Ganzel, C.
Vaxman, Y.
Aviv, A.
Christoforidou, A.
Gavriatopoulou, M.
Shaulov, A.
Verrou, E.
Papanota, A.-M.
Fakinos, G.
Gkioka, A.-I.
Palaska, V.
Triantafyllou, T.
Konstantinidou, P.
Anagnostopoulos, A.
Terpos, E.
Dimopoulos, M.A.
Λέξεις-κλειδιά:
bortezomib; dexamethasone; immunoglobulin; lactate dehydrogenase; lenalidomide; proteasome inhibitor; thalidomide, adult; aged; Article; autologous stem cell transplantation; bone disease; cancer incidence; cancer mortality; cancer prognosis; cancer radiotherapy; cancer recurrence; cancer staging; clinical feature; controlled study; cytogenetics; female; follow up; Greece; human; international cooperation; Israel; macrofocal multiple myeloma; major clinical study; male; multiple myeloma; multivariate analysis; overall survival; plasmacytoma; prediction; priority journal; progression free survival; retrospective study; treatment outcome; treatment response; very elderly; clinical trial; data analysis; incidence; middle aged; multicenter study; multiple myeloma; treatment outcome, Adult; Aged; Aged, 80 and over; Data Analysis; Female; Greece; Humans; Incidence; Israel; Male; Middle Aged; Multiple Myeloma; Retrospective Studies; Treatment Outcome
