The impact of frontline risk-adapted strategy on the overall survival of patients with newly diagnosed multiple myeloma: an analysis of the Singapore multiple myeloma study group

European Journal of Haematology
Daryl TanWee J Chng

Abstract

Risk stratification is vital for prognostication and informing treatment decisions in multiple myeloma (MM). We study the prognostic values of the International Staging System (ISS) and underlying cytogenetics in the bortezomib era and assess the impacts of an upfront risk-adapted approach in the treatment of MM. We compare the overall survival (OS) of 221 patients with MM diagnosed from 2006 to 2009 (era 2) where upfront bortezomib combination was approved for high-risk MM with the OS of 262 patients diagnosed from 2000 to 2005 (era 1) where bortezomib could only be administered at relapse. High-risk MM is defined by the presence of ISS III disease with renal impairment or adverse cytogenetics. Baseline characteristics were comparable between the 2 eras. At median follow-up of 20 months, 0% and 26% of patients had received frontline bortezomib in eras 1 and 2, respectively. The median OS were 4.2 yrs and not reached for eras 1 and 2, respectively (P = 0.03). On multivariate analysis stratified by era, the most significant prognostic factor shifts from cytogenetics in era 1 to the quality of response in era 2. Frontline use of bortezomib in a risk-adapted manner may avert early mortality and is better able to overcome adverse r...Continue Reading

References

Nov 1, 1983·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J R AndersonR D Gelber
Jan 8, 2000·Hematology/oncology Clinics of North America·S V Rajkumar, P R Greipp
Sep 27, 2003·Leukemia·R Fonseca
Mar 3, 2004·Cancer Research·Rafael FonsecaHerve Avet-Loiseau
Jul 21, 2006·Leukemia·B G M DurieUNKNOWN International Myeloma Working Group
Apr 11, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sigurdur Yngvi KristinssonMagnus Björkholm
Jun 27, 2007·British Journal of Haematology·Bart BarlogieJohn D Shaughnessy
Nov 1, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·David DingliMorie A Gertz
Aug 30, 2008·The New England Journal of Medicine·Jesús F San MiguelUNKNOWN VISTA Trial Investigators
Nov 13, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Juan José LahuertaJesús F San Miguel
Jul 28, 2009·Bone Marrow Transplantation·M WangR Alexanian
Oct 15, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jean-Luc HarousseauPhilippe Moreau
Apr 7, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Maria-Victoria MateosJesús F San Miguel
Jul 21, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Hervé Avet-LoiseauJean-Luc Harousseau
Oct 20, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Meletios A DimopoulosJésus San Miguel
Apr 13, 2011·Blood·Joaquin Martinez-LopezUNKNOWN Programa para el Estudio de la Terapé utica en Hemopatía Maligna

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.