Confirmation of the utility of the International Staging System and identification of a unique pattern of disease in Brazilian patients with multiple myeloma

Hungria, Vania T.M.; Maiolino, Ângelo; Martínez, Gracia; Colleoni, Gisele W. B.; Coelho, Érika Oliveira de Miranda; Rocha, Lucila Soares da Silva; Nunes, Renata Ferreira Marques; Bittencourt, Rosane; Oliveira, Luciana Correa Oliveira de; Faria, R. M. O.; Pasqüini, Ricardo; Magalhães, S.M.M.; Souza, César Alexandre de; Neto, Jorge Megid; Barreto, Leandro; Andrade, Eli Iôla Gurgel; Portella, Maria do Socorro Oliveira; Bolejack, Vanessa; Durie, B.

doi:10.3324/haematol.11637

Cited by 39 publications

(52 citation statements)

References 5 publications

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“…The main cause of this loss was early death, related to infection in 60% of cases, and progression of myeloma in 32%. This is likely a reflection of the high proportion of patients in Brazilian hospitals with advanced disease at the time of diagnosis, as reported by Hungria et al in a large retrospective epidemiologic study of MM [21]. In conclusion, a maintenance strategy using thalidomide and dexamethasone after a single ASCT significantly improves PFS in patients with MM.…”

Section: Discussionmentioning

confidence: 57%

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Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression‐free survival in multiple myeloma

et al. 2012

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Despite the good response of stem cell transplant (SCT) in the treatment of multiple myeloma (MM), most patients relapse or do not achieve complete remission, suggesting that additional treatment is needed. We assessed the impact of thalidomide in maintenance after SCT in untreated patients with MM. A hundred and eight patients (<70 years old) were randomized to receive maintenance with dexamethasone (arm A; n 5 52) or dexamethasone with thalidomide (arm B; n 5 56; 200 mg daily) for 12 months or until disease progression. After a median follow-up of 27 months, an intention to treat analysis showed a 2-year progression-free survival (PFS) of 30% in arm A (95% CI 22-38) and 64% in arm B (95% CI 57-71; P 5 0.002), with median PFS of 19 months and 36 months, respectively. In patients who did not achieve at least a very good partial response, the PFS at 2 years was significantly higher when in use of thalidomide (19 vs. 59%; P 5 0.002). Overall survival at 2 years was not significantly improved (70 vs. 85% in arm A and arm B, respectively; P 5 0.27). The addition of thalidomide to dexamethasone as maintenance improved the PFS mainly in patients who did not respond to treatment after SCT. Am. J. Hematol. 87:948-952, 2012. V

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Section: Discussionmentioning

confidence: 57%

“…The 2-year PFS was 30% in arm A (95% CI 22-38) and 64% in arm B (95% CI 57-71; P 5 0.002; Fig. 2B), with median PFS of 19 months (range [15][16][17][18][19][20][21][22] and 36 months (range 22-49), respectively.…”

Section: Resultsmentioning

confidence: 99%

Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression‐free survival in multiple myeloma

et al. 2012

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“…In Brazil, there is no exact knowledge on the incidence of this disease ( 3 ) (B). The median age at diagnosis in national studies is 60.5 years with most cases being diagnosed in the advanced stage of the disease [76.5% in Durie-Salmon (DS) Stage III] ( 3 ) (B).…”

Section: Introductionmentioning

confidence: 99%

Guidelines on the diagnosis and management of multiple myeloma treatment: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Project guidelines: Associação Médica Brasileira - 2012

Hungria¹,

Crusoé²,

Quero³

et al. 2013

Revista Brasileira De Hematologia E Hemoterapia

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“…3 Regarding Latin American epidemiological datasets, little is known about the incidence and clinical features, 3,4 and the exact incidence of MM in Brazil has not yet been determined, 4,5 but according to the International Myeloma Foundation, there are around 30,000 Brazilian MM patients currently under treatment. 6 The management of MM has been revolutionized over the last few years and this has been based on understanding recent advances in MM pathophysiology, discovery of new target pathways and development of novel therapeutic agents.…”

Section: Introductionmentioning

confidence: 99%

Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study

et al. 2016

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CONTEXT AND OBJECTIVE: For the last nine years, hematologists and oncologists have gathered annually at an educational symposium organized by a Brazilian and an American hospital. During the 2015 Board Review, a survey among the attendees evaluated the differences in management and treatment methods for multiple myeloma (MM). DESIGN AND SETTING: Cross-sectional study during an educational hematology symposium in São Paulo, Brazil. METHODS: Hematologists present at the symposium gave responses to an electronic survey by means of mobile phone. RESULTS: Among the 350 attendees, 217 answered the questionnaire. Most of the participants believed that immunotargeting agents (iTA) might be effective for slowing MM progression in heavily pretreated patients (67%) and that continued exposure to therapy might lead to emergence of resistant clones in patients with MM (76%). Most of the physicians use maintenance therapy after hematopoietic stem cell transplantation (95%) and 45% of them would further restrict it to post-transplantation patients with underlying high-risk disease. The first-line drugs used for transplantation-ineligible patients (TI-MM) were bortezomib-thalidomide-dexamethasone (31%), bortezomib-dexamethasone (28%), lenalidomide-dexamethasone (Rd; 17%) and melphalan-based therapy (10%). Lenalidomide was the drug of choice for post-transplantation maintenance for half of the participants. No significant differences were observed regarding age or length of experience. CONCLUSION: The treatment choices for TI-MM patients were highly heterogenous and the melphalan-based regimen represented only 10% of the first-line options. Use of maintenance therapy after transplantation was a common choice. Some results from the survey were divergent from the evidence in the literature.

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Confirmation of the utility of the International Staging System and identification of a unique pattern of disease in Brazilian patients with multiple myeloma

Cited by 39 publications

References 5 publications

Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression‐free survival in multiple myeloma

Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression‐free survival in multiple myeloma

Guidelines on the diagnosis and management of multiple myeloma treatment: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Project guidelines: Associação Médica Brasileira - 2012

Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study

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