Evaluation of prognostic staging systems of multiple myeloma in the era of novel agents

2021 ◽  
Author(s):  
Yufeng Shang ◽  
Yanxia Jin ◽  
Hailing Liu ◽  
Lu Ding ◽  
Xiqin Tong ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Novel Agents ◽  
Staging Systems

Extramedullary Multiple Myeloma Associated With Reduced Overall Survival: A Retrospective Single-Center Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5317-5317 ◽  
Author(s):  
Ido Barkay ◽  
Richard T. Maziarz ◽  
Andy I. Chen ◽  
William Dibb ◽  
Yiyi Chen ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
High Risk ◽  
Staging System ◽  
Novel Agents ◽  
Cell Transplant ◽  
Disease Characteristics ◽  
Staging Systems ◽  
Risk Patients

Abstract Introduction Multiple Myeloma (MM) is an incurable neoplasm, however recent advancements in therapies have led to median overall survival of 7-10 years in standard risk patients. High risk patients still succumb to the disease within 3 to 5 years. Traditionally used clinical prognostic markers such as the International Staging System (ISS), the Durie-Salmon (DS) staging system, and cytogenetics do not adequately predict response to novel agents or overall prognosis. We previously presented data identifying high risk sub-groups that succumb to shorter progression free survival (PFS) and overall survival (OS) after hematopoietic stem cell transplant (HSCT). Extramedullary disease (EMD) was a highly significant risk factor for poor survival. Methods A retrospective single institution cohort study was performed of 251 patients who underwent HSCT for MM between 1/1/2001 and 12/31/2011. Of these 251 patients, 18 were identified as having EMD, which was defined by the presence of ≥ 2 plasmacytomas in organs other than bone marrow or bone at any stage of disease. Data points collected included patient and disease characteristics, ISS and DS stage, cytogenetics and FISH, induction therapy, type and number of HSCT, treatment type and cycles, as well as maintenance therapy. Outcome measures included overall response rate (ORR), PFS and OS. Descriptive statistical analysis was conducted for all primary and secondary endpoints. Univariate and multivariate analysis were conducted using the Cox proportional hazards regression model. Results Patients with EMD represented 6.6% of our total population. Patient and disease characteristics are found in table 1. Seven of 18 patients had died by the time of data collection. With a median follow up time of 29 months, the median PFS and OS for the entire group (n= 251) compared to the EMD group (n= 18) were PFS: 22.3 months (95% CI 19.75 – 30.32) vs. 12.9 and OS: 57.3 months (95% CI: 46.52 - 77.77) vs. 17.2 (Figs 1 and 2). Results of univariate and multivariate analysis are in table 2. Conclusion Extramedullary multiple myeloma represents a small but highly aggressive subgroup of multiple myeloma. It prevails as a poor prognostic indicator despite the use of novel agents, yet it is not included in traditionally used staging systems. Further confirmatory studies are needed, and likely, new therapeutic approaches will be required for MM patients with EMD. Disclosures: Chen: Genzyme: supported database used for this study Other. Scott:Millenium Pharmaceuticals: Membership on an entity’s Board of Directors or advisory committees, Research Funding.

scholarly journals Pegfilgrastim for primary prophylaxis of febrile neutropenia in multiple myeloma

2021 ◽  
Author(s):  
Claudio Cerchione ◽  
Davide Nappi ◽  
Giovanni Martinelli
Keyword(s):  
Multiple Myeloma ◽  
Febrile Neutropenia ◽  
Supportive Care ◽  
Survival Rates ◽  
Primary Prophylaxis ◽  
Secondary Prophylaxis ◽  
Novel Agents ◽  
Severe Side Effect ◽  
Maximum Benefit ◽  
Long Acting

AbstractMultiple myeloma (MM) survival rates have been substantially increased thanks to novel agents that have improved survival outcomes and shown better tolerability than treatments of earlier years. These new agents include immunomodulating imide drugs (IMiD) thalidomide and lenalidomide, the proteasome inhibitor bortezomib (PI), recently followed by new generation IMID pomalidomide, monoclonal antibodies daratumumab and elotuzumab, and next generation PI carfilzomib and ixazomib. However, even in this more promising scenario, febrile neutropenia remains a severe side effect of antineoplastic therapies and can lead to a delay and/or dose reduction in subsequent cycles. Supportive care has thus become key in helping patients to obtain the maximum benefit from novel agents. Filgrastim is a human recombinant subcutaneous preparation of G-CSF, largely adopted in hematological supportive care as “on demand” (or secondary) prophylaxis to recovery from neutropenia and its infectious consequences during anti-myeloma treatment. On the contrary, pegfilgrastim is a pegylated long-acting recombinant form of granulocyte colony-stimulating factor (G-CSF) that, given its extended half-life, can be particularly useful when adopted as “primary prophylaxis,” therefore before the onset of neutropenia, along chemotherapy treatment in multiple myeloma patients. There is no direct comparison between the two G-CSF delivery modalities. In this review, we compare data on the two administrations’ modality, highlighting the efficacy of the secondary prophylaxis over multiple myeloma treatment. Advantage of pegfilgrastim could be as follows: the fixed administration rather than multiple injections, reduction in neutropenia and febrile neutropenia rates, and, finally, a cost-effectiveness advantage.

scholarly journals Management of relapsed and refractory multiple myeloma: novel agents, antibodies, immunotherapies and beyond

Leukemia ◽  
2017 ◽  
Vol 32 (2) ◽  
pp. 252-262 ◽  
Author(s):  
C S Chim ◽  
S K Kumar ◽  
R Z Orlowski ◽  
G Cook ◽  
P G Richardson ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Novel Agents ◽  
Refractory Multiple Myeloma

scholarly journals Risk factors associated with early mortality in patients with multiple myeloma who were treated upfront with a novel agents containing regimen

BMC Cancer ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Sung-Hoon Jung ◽  
◽  
Min-Seok Cho ◽  
Hee Kyung Kim ◽  
Seok Jin Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Early Mortality ◽  
Novel Agents ◽  
Factors Associated

Feasibility and Efficacy of Local Radiation Therapy With Concurrent Novel Agents in Patients With Multiple Myeloma

2013 ◽  
Vol 87 (2) ◽  
pp. S556
Author(s):  
S. Shin ◽  
R. Chouake ◽  
N. Sanfilippo ◽  
A. Mazumder ◽  
J. Silverman
Keyword(s):  
Multiple Myeloma ◽  
Radiation Therapy ◽  
Novel Agents ◽  
Local Radiation

scholarly journals Increased expression of cyclin-D1 on trephine bone marrow biopsies independently predicts for shorter overall survival in patients with multiple myeloma treated with novel agents

2012 ◽  
Vol 87 (7) ◽  
pp. 734-736 ◽  
Author(s):  
Anna Tasidou ◽  
Maria Roussou ◽  
Evangelos Terpos ◽  
Efstathios Kastritis ◽  
Maria Gkotzamanidou ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Overall Survival ◽  
Cyclin D1 ◽  
Novel Agents ◽  
Bone Marrow Biopsies

MM-409: Bendamustine-Bortezomib-Dexamethasone (BVD) in Heavily Pre-Treated Multiple Myeloma: Old/New in the Novel Agents’ Era

2021 ◽  
Vol 21 ◽  
pp. S442
Author(s):  
Claudio Cerchione ◽  
Lucio Catalano ◽  
Davide Nappi ◽  
Fabrizio Pane ◽  
Giovanni Martinelli
Keyword(s):  
Multiple Myeloma ◽  
Novel Agents ◽  
The Novel

scholarly journals Comprehensive evaluation of the revised international staging system in multiple myeloma patients treated with novel agents as a primary therapy

2017 ◽  
Vol 92 (12) ◽  
pp. 1280-1286 ◽  
Author(s):  
Hyungwoo Cho ◽  
Dok Hyun Yoon ◽  
Jung Bok Lee ◽  
Sung-Yong Kim ◽  
Joon Ho Moon ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Comprehensive Evaluation ◽  
Staging System ◽  
Novel Agents ◽  
Primary Therapy ◽  
International Staging System
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