Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project
Jazyk angličtina Země Spojené státy americké Médium electronic
Typ dokumentu časopisecké články
Grantová podpora
P50 CA186781
NCI NIH HHS - United States
U10 CA180819
NCI NIH HHS - United States
U10 CA180888
NCI NIH HHS - United States
PubMed
30470751
PubMed Central
PMC6251924
DOI
10.1038/s41408-018-0155-7
PII: 10.1038/s41408-018-0155-7
Knihovny.cz E-zdroje
- MeSH
- biologické markery MeSH
- Kaplanův-Meierův odhad MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- mnohočetný myelom diagnóza epidemiologie mortalita terapie MeSH
- odds ratio MeSH
- přežívající onkologičtí pacienti * statistika a číselné údaje MeSH
- prognóza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů MeSH
- surveillance populace MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- biologické markery MeSH
PURPOSE: multiple myeloma is considered an incurable hematologic cancer but a subset of patients can achieve long-term remissions and survival. The present study examines the clinical features of long-term survival as it correlates to depth of disease response. PATIENTS & METHODS: this was a multi-institutional, international, retrospective analysis of high-dose melphalan-autologous stem cell transplant (HDM-ASCT) eligible MM patients included in clinical trials. Clinical variable and survival data were collected from 7291 MM patients from Czech Republic, France, Germany, Italy, Korea, Spain, the Nordic Myeloma Study Group and the United States. Kaplan-Meier curves were used to assess progression-free survival (PFS) and overall survival (OS). Relative survival (RS) and statistical cure fractions (CF) were computed for all patients with available data. RESULTS: achieving CR at 1 year was associated with superior PFS (median PFS 3.3 years vs. 2.6 years, p < 0.0001) as well as OS (median OS 8.5 years vs. 6.3 years, p < 0.0001). Clinical variables at diagnosis associated with 5-year survival and 10-year survival were compared with those associated with 2-year death. In multivariate analysis, age over 65 years (OR 1.87, p = 0.002), IgA Isotype (OR 1.53, p = 0.004), low albumin < 3.5 g/dL (OR = 1.36, p = 0.023), elevated beta 2 microglobulin ≥ 3.5 mg/dL (OR 1.86, p < 0.001), serum creatinine levels ≥ 2 mg/dL (OR 1.77, p = 0.005), hemoglobin levels < 10 g/dL (OR 1.55, p = 0.003), and platelet count < 150k/μL (OR 2.26, p < 0.001) appeared to be negatively associated with 10-year survival. The relative survival for the cohort was ~0.9, and the statistical cure fraction was 14.3%. CONCLUSIONS: these data identify CR as an important predictor of long-term survival for HDM-ASCT eligible MM patients. They also identify clinical variables reflective of higher disease burden as poor prognostic markers for long-term survival.
Cancer Research and Biostatistics Seattle Washington United States
Department of Hematology Malmo University Hospital Malmo Sweden
Department of Internal Medicine 5 University Hospital Heidelberg Heidelberg Germany
Department of Internal Medicine Division of Hematology Mayo clinic Rochester MN United States
Division of Hematology Mayo Clinic Rochester MN United States
Gachon University Gil Medical Center Gachon University School of Medicine Incheon Republic of Korea
Hematology Mount Sinai University New York United States
Hospital Universitario 12 de Octubre Madrid Spain
MIRT UAMS Myeloma Insitute Little Rock United States
Seragnoli Institute of Hematology Bologna University School of Medicine Bologna Italy
service d'Hematologie CHU de Nantes Nantes France
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