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Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients
Multiple myeloma (MM) is a hematologic cancer defined by an abnormal development of clonal plasma cells in the bone marrow, releasing vast quantities of immunoglobulins and different proteins. In the majority of patients, MM remains incurable despite decades of medical improvement and a number of tr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9689544/ https://www.ncbi.nlm.nih.gov/pubmed/36354730 http://dx.doi.org/10.3390/curroncol29110670 |
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author | Potre, Cristina Borsi, Ema Potre, Ovidiu Samfireag, Miruna Costachescu, Dan Cerbu, Bianca Bratosin, Felix Secosan, Cristina Negrean, Rodica Anamaria |
author_facet | Potre, Cristina Borsi, Ema Potre, Ovidiu Samfireag, Miruna Costachescu, Dan Cerbu, Bianca Bratosin, Felix Secosan, Cristina Negrean, Rodica Anamaria |
author_sort | Potre, Cristina |
collection | PubMed |
description | Multiple myeloma (MM) is a hematologic cancer defined by an abnormal development of clonal plasma cells in the bone marrow, releasing vast quantities of immunoglobulins and different proteins. In the majority of patients, MM remains incurable despite decades of medical improvement and a number of treatment breakthroughs. Frontline standard-of-care has little long-term success, with the majority of patients eventually relapsing, although the overall progression-free survival (PFS) has improved significantly in the last ten years. Patients who are eligible for a transplant have the highest PFS rate at 5 years, depending on medication response and other various factors that are yet to be discovered. Therefore, the current study aimed to evaluate the response to VCD (bortezomib, cyclophosphamide, dexamethasone) and VTD (bortezomib, thalidomide, dexamethasone) used as pretransplant regimens, as well as to compare responses between thalidomide and lenalidomide used as maintenance therapy posttransplant. This retrospective study was performed on a group of 105 hospitalized patients in the Hematology Department of the Timisoara Municipal Emergency Clinical Hospital between January 2016 and December 2021. Data was collected from the paper records of patients with MM who were under-followed. The treatment regimens used as induction therapy were either VCD or VTD if cyclophosphamide was contraindicated. Of the 105 patients, 27 became eligible for bone marrow transplantation. Furthermore, they received maintenance therapy which was based on either lenalidomide with dexamethasone or thalidomide with dexamethasone. Of the 62 patients treated with VTD, 17.7% were in complete remission before stem cell transplantation. Of the 43 patients treated with VCD, 37.2% were in complete remission. The 5-year mean progression-free survival (PFS) in the entire cohort was better in the group treated with the VTD regimen (31.6 vs. 27.2 months). However, in the 27 patients undergoing maintenance after ASCT, the PFS with thalidomide was 35.5 months (95% CI = 27–42), while the PFS rate in those receiving maintenance treatment with lenalidomide was 46.1 months (95% CI = 20–73). VCD proved to be superior to VTD in inducing complete pretransplant responses. Regarding maintenance therapy, patients from the lenalidomide group had superior responses compared with those under thalidomide. |
format | Online Article Text |
id | pubmed-9689544 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96895442022-11-25 Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients Potre, Cristina Borsi, Ema Potre, Ovidiu Samfireag, Miruna Costachescu, Dan Cerbu, Bianca Bratosin, Felix Secosan, Cristina Negrean, Rodica Anamaria Curr Oncol Article Multiple myeloma (MM) is a hematologic cancer defined by an abnormal development of clonal plasma cells in the bone marrow, releasing vast quantities of immunoglobulins and different proteins. In the majority of patients, MM remains incurable despite decades of medical improvement and a number of treatment breakthroughs. Frontline standard-of-care has little long-term success, with the majority of patients eventually relapsing, although the overall progression-free survival (PFS) has improved significantly in the last ten years. Patients who are eligible for a transplant have the highest PFS rate at 5 years, depending on medication response and other various factors that are yet to be discovered. Therefore, the current study aimed to evaluate the response to VCD (bortezomib, cyclophosphamide, dexamethasone) and VTD (bortezomib, thalidomide, dexamethasone) used as pretransplant regimens, as well as to compare responses between thalidomide and lenalidomide used as maintenance therapy posttransplant. This retrospective study was performed on a group of 105 hospitalized patients in the Hematology Department of the Timisoara Municipal Emergency Clinical Hospital between January 2016 and December 2021. Data was collected from the paper records of patients with MM who were under-followed. The treatment regimens used as induction therapy were either VCD or VTD if cyclophosphamide was contraindicated. Of the 105 patients, 27 became eligible for bone marrow transplantation. Furthermore, they received maintenance therapy which was based on either lenalidomide with dexamethasone or thalidomide with dexamethasone. Of the 62 patients treated with VTD, 17.7% were in complete remission before stem cell transplantation. Of the 43 patients treated with VCD, 37.2% were in complete remission. The 5-year mean progression-free survival (PFS) in the entire cohort was better in the group treated with the VTD regimen (31.6 vs. 27.2 months). However, in the 27 patients undergoing maintenance after ASCT, the PFS with thalidomide was 35.5 months (95% CI = 27–42), while the PFS rate in those receiving maintenance treatment with lenalidomide was 46.1 months (95% CI = 20–73). VCD proved to be superior to VTD in inducing complete pretransplant responses. Regarding maintenance therapy, patients from the lenalidomide group had superior responses compared with those under thalidomide. MDPI 2022-11-08 /pmc/articles/PMC9689544/ /pubmed/36354730 http://dx.doi.org/10.3390/curroncol29110670 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Potre, Cristina Borsi, Ema Potre, Ovidiu Samfireag, Miruna Costachescu, Dan Cerbu, Bianca Bratosin, Felix Secosan, Cristina Negrean, Rodica Anamaria Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients |
title | Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients |
title_full | Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients |
title_fullStr | Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients |
title_full_unstemmed | Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients |
title_short | Assessing Pretransplant and Posttransplant Therapy Response in Multiple Myeloma Patients |
title_sort | assessing pretransplant and posttransplant therapy response in multiple myeloma patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9689544/ https://www.ncbi.nlm.nih.gov/pubmed/36354730 http://dx.doi.org/10.3390/curroncol29110670 |
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