Age and aging in blood disorders: multiple myeloma

Zweegman, Sonja; Palumbo, Antônio; Bringhen, Sara; Sonneveld, Pieter

doi:10.3324/haematol.2014.110296

Cited by 49 publications

(38 citation statements)

References 32 publications

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“…[5][6][7] Patients with MM age 75 years or older are an understudied population. 8 Because of increased comorbidities and altered pharmacodynamics, older patients are susceptible to adverse events (AEs) that may negatively affect duration of treatment and, consequently, longterm outcomes. 9,10 Combination therapies including melphalan, prednisone, and thalidomide (MPT); bortezomib, melphalan, and prednisone; and lenalidomide and low-dose dexamethasone (Rd) are considered standard treatment options in many parts of the world for older patients with newly diagnosed MM who are ineligible for stem-cell transplantation (SCT).…”

Section: Introductionmentioning

confidence: 99%

Updated Outcomes and Impact of Age With Lenalidomide and Low-Dose Dexamethasone or Melphalan, Prednisone, and Thalidomide in the Randomized, Phase III FIRST Trial

Hulin

Belch

Shustik

et al. 2016

JCO

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Purpose This analysis of the FIRST trial in patients with newly diagnosed multiple myeloma (MM) ineligible for stem-cell transplantation examined updated outcomes and impact of patient age. Patients and Methods Patients with untreated symptomatic MM were randomly assigned at a one-to-one-to-one ratio to lenalidomide plus low-dose dexamethasone until disease progression (Rd continuous), Rd for 72 weeks (18 cycles; Rd18), or melphalan, prednisone, and thalidomide (MPT; 72 weeks), stratified by age (≤ 75 v > 75 years), disease stage (International Staging System stage I/II v III), and country. The primary end point was progression-free survival. Rd continuous and MPT were primary comparators. Results Between August 21, 2008, and March 7, 2011, 1,623 patients were enrolled (Rd continuous, n = 535; Rd18, n = 541; MPT, n = 547), including 567 (35%) age older than 75 years. Higher rates of advanced-stage disease and renal impairment were observed in patients older than 75 versus 75 years of age or younger. Rd continuous reduced the risk of progression or death compared with MPT by 31% (hazard ratio [HR], 0.69; 95% CI, 0.59 to 0.80; P < .001) overall, 36% (HR, 0.64; 95% CI, 0.53 to 0.77; P < .001) in patients age 75 years or younger, and 20% (HR, 0.80; 95% CI, 0.62 to 1.03; P = .084) in those age older than 75 years. Median overall survival was longer with Rd continuous than with MPT, including a 14-month difference in patients age older than 75 years. Progression-free survival with Rd18 was similar to that with MPT, and overall survival with Rd18 was marginally inferior to that with Rd continuous. Rates of grade 3 to 4 treatment-emergent adverse events were similar for Rd continuous-treated patients age 75 years or older and those age older than 75 years; however, older patients had more frequent lenalidomide dose reductions. Conclusion Results support Rd continuous treatment as a new standard of care for stem-cell transplantation-ineligible patients with newly diagnosed MM of all ages.

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Section: Introductionmentioning

confidence: 99%

Updated Outcomes and Impact of Age With Lenalidomide and Low-Dose Dexamethasone or Melphalan, Prednisone, and Thalidomide in the Randomized, Phase III FIRST Trial

Hulin

Belch

Shustik

et al. 2016

JCO

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“…It accounts for approximately 1% of neoplastic diseases, 13% of hematologic cancers, and 2% of cancer related mortality. The median age at diagnosis is approximately 70 years, but 37% of patients are younger than 65 years [1,2].…”

Section: Introductionmentioning

confidence: 99%

Result of Bortezomib Induction Therapy Prior to Stem Cell Transplantation in Newly Diagnosed Multiple Myeloma Cases in Mongolia

Batsukh,

Norov,

Jigjidkhorloo

et al. 2017

Cent. Asian j. Med. Sci.

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Objectives:For last 5 years, we have focused on establishing autologous stem cell transplantation (ASCT) in Mongolia. Herein, we report on three Mongolian multiple myeloma (MM) cases treated with bortezomib and dexamethasone (VD) prior to ASCT. Methods: The MM diagnosis was confirmed by bone marrow aspiration, urine protein electrophoresis, and serum protein electrophoresis. Results: Circulating white blood cells appeared 8-10 days after ASCT. Platelet levels recovered 10 -15 days after ASCT. Conclusion: In our MM cases, the VD regimen prior to ASCT obtained good response rates without the impairment of stem cells.

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“…It is also contributing to an ever-increasing utilization of autologous stem cell transplantation (ASCT), by making a greater number of patients ⩾ 65 years eligible for this procedure. [1][2][3] Recent reports have documented a better event-free survival with the use of maintenance therapy (with interferon-alfa, bortezomib and immunomodulatory drugs) after ASCT in elderly patients. 4 Data on the benefits of bortezomib and immunomodulatory drugs in the induction phase followed by ASCT in the elderly population are also emerging.…”

mentioning

confidence: 99%

Impact of novel agents followed by autologous hematopoietic stem cell transplantation for multiple myeloma patients aged 65 years or older: a retrospective single Institutional analysis

Minoia

Pisapia

Palazzo

et al. 2015

Bone Marrow Transplant

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Age and aging in blood disorders: multiple myeloma

Cited by 49 publications

References 32 publications

Updated Outcomes and Impact of Age With Lenalidomide and Low-Dose Dexamethasone or Melphalan, Prednisone, and Thalidomide in the Randomized, Phase III FIRST Trial

Updated Outcomes and Impact of Age With Lenalidomide and Low-Dose Dexamethasone or Melphalan, Prednisone, and Thalidomide in the Randomized, Phase III FIRST Trial

Result of Bortezomib Induction Therapy Prior to Stem Cell Transplantation in Newly Diagnosed Multiple Myeloma Cases in Mongolia

Impact of novel agents followed by autologous hematopoietic stem cell transplantation for multiple myeloma patients aged 65 years or older: a retrospective single Institutional analysis

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