Περίληψη:
We have studied the efficacy and the prognostic impact of novel agents in 50 primary plasma cell leukemia (pPCL) patients registered in our database. Eighty percent of patients were treated upfront with novel agent-based combinations; 40% underwent autologous stem cell transplantation (ASCT). Objective response rate was 76; 38% achieved at least very good partial response (≥vgPR) and this correlated significantly with bortezomib-based therapy plus ASCT. At the time of evaluation, 40 patients had died. Early mortality rate (≤1 month) was 6%. Median progression-free survival (PFS) and overall survival (OS) were 12 months and 18 months respectively, both significantly longer in patients treated with bortezomib-based therapy + ASCT vs. others (PFS: 18 vs. 9 months; p = 0.004, OS: 48 vs. 14 months; p = 0.007). Bortezomib-based therapy + ASCT predicted for OS in univariate analysis. In multivariate analysis, achievement of ≥vgPR and LDH ≥ 300 U/L were significant predictors for OS. These real-world data, based on one of the largest reported national multicenter series of pPCL patients treated mostly with novel agents support that, among the currently approved induction therapies, bortezomib-based regimens are highly effective and reduce the rate of early mortality whereas in combination with ASCT consolidation they prolong OS. © 2018 The Author(s).
Συγγραφείς:
Katodritou, E.
Terpos, E.
Delimpasi, S.
Kotsopoulou, M.
Michalis, E.
Vadikolia, C.
Kyrtsonis, M.-C.
Symeonidis, A.
Giannakoulas, N.
Vadikolia, C.
Michael, M.
Kalpadakis, C.
Gougopoulou, T.
Prokopiou, C.
Kaiafa, G.
Christoulas, D.
Gavriatopoulou, M.
Giannopoulou, E.
Labropoulou, V.
Verrou, E.
Kastritis, E.
Konstantinidou, P.
Anagnostopoulos, A.
Dimopoulos, M.A.
Λέξεις-κλειδιά:
antineoplastic agent; Bence Jones protein; bortezomib; carfilzomib; dexamethasone; hemoglobin; ixazomib; lactate dehydrogenase; lenalidomide; melphalan; pomalidomide; prednisone; thalidomide; bortezomib, adult; aged; anemia; Article; autologous stem cell transplantation; bone marrow suppression; cancer prognosis; clinical article; female; flow cytometry; fluorescence in situ hybridization; follow up; gastrointestinal toxicity; hemoglobin blood level; human; hypercalcemia; lactate dehydrogenase blood level; male; mortality rate; neutropenia; overall survival; peripheral neuropathy; plasma cell leukemia; plasmacytoma; primary plasma cell leukemia; progression free survival; retrospective study; salvage therapy; thrombocytopenia; treatment response; autograft; clinical trial; disease free survival; epidemiology; Greece; middle aged; mortality; multicenter study; pathology; plasma cell leukemia; stem cell transplantation; survival rate; very elderly, Adult; Aged; Aged, 80 and over; Autografts; Bortezomib; Disease-Free Survival; Female; Greece; Humans; Leukemia, Plasma Cell; Male; Middle Aged; Retrospective Studies; Stem Cell Transplantation; Survival Rate
