Autologous stem cell transplantation in the treatment of multiple myeloma patients with 17p deletion

Czyż, Jarosław; Jurczyszyn, Artur; Szudy‐Szczyrek, Aneta; Koclęga, Anna; Jachalska, Anna; Dzierżak‐Mietła, Monika; Puła, Bartosz; Jamroziak, Krzysztof; Usnarska−Zubkiewicz, Lidia; Gil, Lidia; Romejko‐Jarosińska, Joanna; Waszczuk‐Gajda, Anna

doi:10.20452/pamw.15139

Cited by 5 publications

(4 citation statements)

References 4 publications

(4 reference statements)

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“…30 In the era of novel antimyeloma agents, the presence of primary high -risk CAs, such as t(4;14), t(14;16), t(14;20), and, in particular, del(17p), still negatively impacts the outcomes in patients newly diagnosed with MM. 31,32 The prevalence of primary high -risk CAs is significant, with 15%, 3% to 5%, and 5% to 8% of patients with newly diagnosed MM affected by t(4;14), t(14;16), and del(17p), respectively. 33,34 In our database, the incidence of high -risk CAs at the time of the diagnosis of MM was in accordance with previously reported data with t(4;14), t(14;16), and del(17p) found in 10%, 2%, and 7% of patients, respectively.…”

Section: Results Patients' Baseline Characteristics and Cytogenetic Evaluationmentioning

confidence: 99%

The impact of cytogenetic evolution and acquisition of del(17p) on the prognosis of multiple myeloma patients

Salomon-Perzyński

Bluszcz²,

Krzywdzińska

et al. 2020

Polish Archives of Internal Medicine

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Prognostic impact of cytogenetic evolution in multiple myeloma 483 transplant (auto -HSCT) 11 have significantly improved the prognosis of patients with MM. However, most cases of MM are still incurable.Recent studies using next -generation sequencing (NGS) approaches have provided evidence that MM is characterized by spatial and temporal genetic heterogeneity and is composed of multiple populations of genetically distinct subclones, which evolve over time following a pattern INTRODUCTION Multiple myeloma (MM) is the third most common hematologic malignancy in the European Union, with approximately 33 000 new cases and 20 000 deaths annually. 1 The introduction of novel agents, such as proteasome inhibitors (PIs), 2-4 immunomodulatory drugs (IMiDs), 5 -7 and anti -CD38 monoclonal antibodies 8 -10 along with high -dose melphalan followed by autologous hematopoietic stem cell

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Section: Results Patients' Baseline Characteristics and Cytogenetic Evaluationmentioning

confidence: 99%

The impact of cytogenetic evolution and acquisition of del(17p) on the prognosis of multiple myeloma patients

Salomon-Perzyński

Bluszcz²,

Krzywdzińska

et al. 2020

Polish Archives of Internal Medicine

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“…In addition to these ndings, we also found the obvious advantage of autologous hematopoietic stem cell transplantation in improving the survival of extramedullary multiple myeloma patients. In the study carried by Czyż J. et al, autologous stem cell transplantation was an important factor in improving survival (HR=3.23; 95%CI: 1.52-6.84) in patients with multiple myeloma with 17p deletion (Czyż J et al 2020). For newly diagnosed multiple myeloma paitients, autologous HSCT could improve the PFS (Cavo M et al 2020).…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical characteristics, efficacy and survival of newly diagnosed extramedullary multiple myeloma patients between single and multiple sites invasion

Zhao

Zhou

2021

Preprint

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PurposeWe aimed to compare the clinical characteristics, efficacy and survival of newly diagnosed extramedullary multiple myeloma patients (EMM) between single and multiple sites invasion.MethodsA total of 90 EMM patients were included. The characteristics including gender, age, Durie-Salmon stage, ISS stage, hemoglobin, blood calcium, creatinine, M-protein types, β2-microglobulin, lactate dehydrogenase and so on were analyzed. We compared the overall remission rates (ORR) in patients with single site invasion and multiple sites invasion. Progression free survival (PFS) and overall survival (OS) were also compared.ResultsPatients with multiple sites invasion had higher lactate dehydrogenase than single site invasion (179.0U/L vs. 154.7U/L, P=0.016). The ORR in patients with single site invasion (72.1%) was not significantly higher than multiple sites invasion (68.2%) (P=0.690). In patients with multiple sites invasion, PI-based regimen (78.9% vs. 33.3%, P=0.035) or PI combined with IMiD regimen (84.6% vs. 33.3%, P=0.026) could achieve superior efficacy than routine chemotherapy. Among patients with single site invasion, the COX model analysis showed that proteasome inhibitors combined with immunomodulators could significantly improve the PFS (HR=0.080, 95%CI: 0.007-0.855, P=0.037). Among patients with multiple sites invasion, the associations of RISS 3 with poor PFS (HR=4.081, 95%CI: 1.533-10.865, P=0.005) and OS (HR=13.295, 95%CI: 3.219-54.907, P=0.000) were showed.ConclusionRISS stage 3 was possibly associated with poor survival of extramedullary multiple myeloma patients with multiple sites invasion. We propose a prospective and large-sample study to explore the effects of new drugs and autologous hematopoietic stem cell transplantation on survival of patients at RISS stage 3.

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“…Patient 2 and Patient 3 didn’t sustain clinical benefit with XVd for as long as Patient 1; however, the disease responded to this selinexor-containing regimen after approximately 2 to 4 months of treatment, even though both patients were heavily pretreated for MM, had disease refractory to bortezomib and dexamethasone, and had the del(17p) cytogenetic abnormality. This genetic characteristic is an important prognostic factor of treatment outcomes [ 12 ] as well as a very high-risk feature and an indicator for poor outcome [ 13 ]; although, patients with del(17p) in the BOSTON study had a particularly strong response to XVd as compared with Vd [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Selinexor in Patients from Argentina with Multiple Myeloma Treated with Multiple Prior Therapies: A Case Series

2022

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Case series Patients: Male, 72-year-old • Female, 59-year-old • Female, 62-year-old Final Diagnosis: Multiple myeloma Symptoms: Anemia • hypercalcemia • lytic bone lesions Medication: Selinexor Clinical Procedure: — Specialty: Hematology Objective: Unusual setting of medical care Background: Numerous treatment options are available for patients with multiple myeloma (MM). Because of the course of the disease, most patients will experience serial relapse or the MM will become refractory to most of these treatments, leaving patients with few or no treatment options over time. Selinexor, a treatment with a novel mechanism of action, is an oral selective inhibitor of nuclear export (SINE) compound that blocks exportin 1, the major nuclear exporter of tumor suppressor proteins. Case Reports: In this case series, we report on treatment with the weekly oral administration of selinexor combined with bortezomib and dexamethasone (XVd) in 3 patients from Argentina who were heavily treated (5–7 prior therapies) for MM that relapsed or was refractory to each previous treatment. Two patients had the high-risk cytogenetic abnormality del(17p). All 3 patients experienced efficacy with XVd reaching a best response of partial response or very good partial response. These responses were consistent with those of patients from the BOSTON study who were treated with XVd but were less heavily pretreated (1–3 prior therapies) and had a shorter median time since diagnosis of MM (7 years vs 3.7 years). The 3 patients experienced adverse events (AEs) that included nausea, thrombocytopenia, asthenia, and fatigue, which were similar to the most commonly reported AEs associated with selinexor treatment. Conclusions: With its oral administration, novel mechanism of action, and responses in heavily pretreated patients, selinexor may help to address an important clinical need in the treatment of patients with relapsed/refractory MM.

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Autologous stem cell transplantation in the treatment of multiple myeloma patients with 17p deletion

Cited by 5 publications

References 4 publications

The impact of cytogenetic evolution and acquisition of del(17p) on the prognosis of multiple myeloma patients

The impact of cytogenetic evolution and acquisition of del(17p) on the prognosis of multiple myeloma patients

Comparison of clinical characteristics, efficacy and survival of newly diagnosed extramedullary multiple myeloma patients between single and multiple sites invasion

Selinexor in Patients from Argentina with Multiple Myeloma Treated with Multiple Prior Therapies: A Case Series

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