Autologous stem cell transplant for multiple myeloma: Impact of melphalan dose on the transplant outcome

Kumar, Lalit; Sahoo, Ranjit Kumar; Kumar, Sudhir; Baa, Annie Kanchan; Tansir, Ghazal; Pathak, Neha; Malik, Prabhat Singh; Sharma, Om Dutt; Mathew, Anisha; Jha, Ankit; Gupta, Ritu; Sharma, Atul; Biswas, Ahitagni; Kumar, Rakesh; Thulkar, Sanjay; Malik, Soumyaranjan; Dutt, Ashish

doi:10.1080/10428194.2022.2148214

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…Напротив, L. Kumar и соавт. [11] не обнаружили различий в медиане ВБП и ОВ в группах с дозой мелфалана до 150 или 200 мг/м 2 в составе режима кондиционирования. Аналогичные результаты представлены G. Ghilardi и соавт.…”

Section: Discussionunclassified

“…Результаты собственного исследования и данные литературы дают основание предположить, что выбор интенсивности режима кондиционирования должен базироваться на анализе показателей, характеризующих состояние пациента и статус заболевания в совокупности с вариантом индукционной терапии и планируемым лечением в посттрансплантационный период [11,22,23].…”

Section: Discussionunclassified

“…Учитывая публикации, свидетельствующие об эффективности аутоТГСК независимо от возраста [8][9][10][11][12][13], а также преимущественное направление врачами молодых больных на данный вид высокотехнологичной медицинской помощи, мы провели ретроспективное сравнительное исследование по оценке токсичности и эффективности трансплантации у больных ММ разного возраста.…”

Section: Introductionunclassified

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Efficacy of Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Patients Aged over 60 Years

Кострома,

Юдина,

Сабитова

et al. 2024

Clinical Oncohematology

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Aim. To compare toxicity and efficacy of high-dose melphalan chemotherapy with subsequent autologous hematopoietic stem cell transplantation (auto-HSCT) in multiple myeloma (MM) patients aged under and over 60 years. Materials & Methods. The retrospective analysis was conducted on the data of 107 MM patients, 78 of them were aged under 60 years (median 54 years), and 29 of them were aged 61 years and older (median 63 years). All patients received auto-HSCT in the period of 2017–2022. Single and tandem auto-HSCT were performed in 92 and 15 patients, respectively. Patients with tandem auto-HSCT (n = 15), lost to follow-up patients (n = 8), and patients who died during early post-transplant period (n = 4) were excluded from survival analysis. Survival rates were calculated based on the date of auto-HSCT. Results. A comparative evaluation of the results in two age groups showed a significant difference in the number of patients treated with ixazomib during the induction period (р = 0.019) and cyclophosphamide 3 g/m2 as part of auto-HSC mobilization (р = 0.014), as well as 200 or 140 mg/m2 melphalan as part of conditioning regimen (р = 0.039 and р = 0.009, respectively). With a follow-up median of 13 months (range 1–57 months), the median progression-free survival in the groups ≤ 60 years vs. > 60 years was 32 and 47 months, respectively (hazard ratio [HR] 0.688; 95% confidence interval [95% CI] 0.270–1.754; p = 0.704). The median overall survival in patients aged under 60 years appeared to be 57 months, it was not reached in patients aged 61 years and older (HR 0.689; 95% CI 0.169–2.803; р = 0.577). Conclusion. The results of the study suggest that all newly diagnosed MM patients aged under 70 years should be regarded as being eligible for auto-HSCT.

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Section: Discussionunclassified

Section: Introductionunclassified

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Efficacy of Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Patients Aged over 60 Years

Кострома,

Юдина,

Сабитова

et al. 2024

Clinical Oncohematology

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“…Long-term follow up of 12 patients with MM post tandem ASCT, in the era preceding the availability of novel therapies, had shown early post-transplant toxicities including diastolic dysfunction, increased left atrial pressure, and functional mitral regurgitation, which were clinically silent and reversible upon follow up over 6 years [ 15 ]. A recent retrospective analysis of patients who underwent ASCT with either Melphalan 150 or 200 mg/m 2 (including around 459 total patients over the period extending between 1995 and 2019), has reported a low incidence of cardiac toxicity (around 2.6%), without specifying the type of toxicity, however noting a slightly higher incidence in the 150 mg/m 2 group, possibly related to pre-transplant underlying comorbidities [ 16 ].…”

Section: Conventional Chemotherapymentioning

confidence: 99%

Cardiac toxicities in multiple myeloma: an updated and a deeper look into the effect of different medications and novel therapies

et al. 2023

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With the continuous improvement in survival of cancer patients, including those with multiple myeloma, related to the novel treatment agents and therapeutic approaches, the probability for patients to develop cardiovascular disease has significantly increased, especially in elderly patients and those with additional risk factors. Multiple myeloma is indeed a disease of the elderly population and so these patients are, solely by age, at an increased risk of cardiovascular disease. Risk factors for these events can be patient-, disease- and/or therapy-related, and they have been shown to adversely impact survival. Cardiovascular events affect around 7.5% of patients with multiple myeloma and the risk for different toxicities has considerably varied across trials depending on patients’ characteristics and treatment utilized. High grade cardiac toxicity has been reported with immunomodulatory drugs (odds ratio [OR] around 2), proteasome inhibitors (OR 1.67–2.68 depending on the specific agent, and generally higher with carfilzomib), as well as other agents. Cardiac arrhythmias have also been reported with various therapies and drug interaction plays a significant role in that setting. Comprehensive cardiac evaluation before, during and after various anti-myeloma therapy is recommended and the incorporation of surveillance strategies allows early detection and management resulting in improved outcomes of these patients. Multidisciplinary interaction including hematologists and cardio-oncologists is critical for optimal patient care.

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Clinical factors associated with autologous stem cell transplantation outcomes in multiple myeloma: upfront transplant with MEL200 remains the standard of care

Bostankolu Değirmenci,

Yegin,

Akdemir

et al. 2023

Ann Hematol

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Autologous stem cell transplant for multiple myeloma: Impact of melphalan dose on the transplant outcome

Cited by 5 publications

References 26 publications

Efficacy of Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Patients Aged over 60 Years

Efficacy of Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Patients Aged over 60 Years

Cardiac toxicities in multiple myeloma: an updated and a deeper look into the effect of different medications and novel therapies

Clinical factors associated with autologous stem cell transplantation outcomes in multiple myeloma: upfront transplant with MEL200 remains the standard of care

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