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Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone

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Author(s)
Ho Sup LeeKihyun KimJe-Jung LeeSung-Soo YoonSoo-Mee BangJin Seok KimHyeon-Seok EomDok Hyun YoonYoojin LeeHo-Jin ShinYong ParkJae-Cheol JoWon Sik LeeYoung Rok DoYeung-Chul MunMark Hong LeeHyo Jung KimSung-Hyun KimMin Kyoung KimSung-Nam LimSeong Kyu ParkJun Ho YiJae Hoon LeeChang-Ki Min
Keimyung Author(s)
Do, Young Rok
Department
Dept. of Internal Medicine (내과학)
Journal Title
International Journal of Hematology
Issued Date
2020
Volume
113
Issue
1
Keyword
Elderly multiple myelomaRelapsed and refractoryLenalidomide and dexamethasoneFrailtySurvival
Abstract
We compared efficacy and safety, according to frailty, of elderly patients with relapsed and refractory multiple myeloma (RRMM) treated with lenalidomide and dexamethasone (Rd), for whom bortezomib treatment had failed. Patients, 164 (52.9%) and 146 (47.1%), were classified as non-frail and frail using a simplified frailty scale. The overall response rates (ORR) and survival outcomes were lower in frail than in non-frail patients (ORR: 56.2% vs. 67.7%, P = 0.069; median progression free survival: 13.17 vs. 17.80 months, P = 0.033; median overall survival: 23.00 vs. 36.27 months, P = 0.002, respectively). The number of treatment emergent adverse events in grade 3 or worse was higher in frail than in non-frail patients (41.8% vs. 24.4%, P = 0.002, respectively). In frail patients, independent poor prognostic factors for survival were two or more Charlson comorbidity index (CCI) score, prior to exposure to both bortezomib and thalidomide, and achieved less than partial response In conclusion, frailty could predict clinical outcomes of Rd treatment in elderly patients with RRMM who had failed prior bortezomib. In frail patients, lower CCI in addition to less previous treatment exposure and deep response were associated with better survival.
Keimyung Author(s)(Kor)
도영록
Publisher
School of Medicine (의과대학)
Citation
Ho Sup Lee et al. (2020). Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone. International Journal of Hematology, 113(1), 81–91. doi: 10.1007/s12185-020-02988-6
Type
Article
ISSN
1865-3775
Source
https://link.springer.com/article/10.1007%2Fs12185-020-02988-6
DOI
10.1007/s12185-020-02988-6
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43111
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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