PS02.112: A RETROSPECTIVE STUDY OF NEOADJUVANT 5-FU, DOCETAXEL, AND NEDAPLATIN (UDON) COMBINATION CHEMOTHERAPY FOR ADVANCED ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 152-153
Author(s):  
Yutaka Kimura ◽  
Osamu Shiraishi ◽  
Hisato Kawakami ◽  
Hiroto Ueda ◽  
Mitsuru Iwama ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Retrospective Study ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
High Dose ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Triplet Regimen

Abstract Background In Japan, pre-operative5-FU and cisplatin (CDDP) (FP) combination therapy has been the standard neoadjuvant chemotherapy (NAC) for advanced resectable esophageal cancer (EC), whereas the efficacy of docetaxel (DTX)-containing triplet regimen, FP plus DTX has been reported (Yamasaki M, et al, Ann Oncol 2017). However, for frail patients, such as patients with old age, chronic renal failure, poor performance status, severe commodities or malnutrition, high dose CDDP is not generally recommended in terms of toxicity. We have been developing non-CDDP-containing triplet regimen, 5-FU, DTX, and nedaplatin (NED) (UDON) on a phase I/II trial basis. This retrospective study aimed to investigate the safety and efficacy of NAC with UDON combination for advanced EC. Methods Eleven patients with advanced resectable EC who were unsuitable for the administration of high dose CDDP were enrolled in this study. Patients received two cycles of NAC with UDON (5-FU, 640 or 800 mg/m2, day1–5, DTX, 28 or 35 mg/m2, day1 and 15 and NED, 72 or 90 mg/m2, day1, q28) followed by esophagectomy. Primary endpoint was response rate and secondary endpoint was adverse event (AE). Results The median age was 73 years (range: 58–80) with eight patients being aged 70 or older. ECOG PS was 1/2: 7/4. The main location of the tumor was Ce/Ut/Mt/Lt/Ae: 1/1/7/1/1 and cStage was IIA/IIB/IIIA/IIIB/IIIC/IV: 2/2/4/0/2/1. The RR (CR + PR) was 82% (CR/PR/SD/PD: 1/8/2/0). The pathological response was grade 0/1a/1b/2/3: 2/3/3/2/1. Major grade 3 or 4 adverse events included neutropenia (27%), febrile neutropenia (27%), diarrhea (18%), enteritis (9%) and hyponatremia (27%). The postoperative morbidity included recurrent nerve palsy (36%), aspiration (27%), pneumonia (18%), anastomotic leakage (9%) and delirium (36%). There was no treatment-related death and no reoperation. Conclusion NAC with UDON for advanced resectable EC unsuitable for the administration of high dose CDDP might be feasible and effective. We are planning a phase II clinical study based on the present results. Disclosure All authors have declared no conflicts of interest.

scholarly journals Cumulative D-Index Predicts the Duration of Febrile Neutropenia in AML Patients

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5180-5180
Author(s):  
Hiroyuki Kubo ◽  
Osamu Imataki ◽  
Shumpei Uchida ◽  
Shigeyuki Yokokura ◽  
Makiko Uemura ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Febrile Neutropenia ◽  
Induction Chemotherapy ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Poor Performance ◽  
Severe Neutropenia ◽  
Poor Performance Status ◽  
High Dose ◽  
Consolidation Therapy

Abstract Background: Prolongation of severe neutropenia is known to predict the onset of pneumonia and invasive fungal infection in patients undergoing chemotherapy. The D-index is a promising tool to assess the severity of neutropenia, and the utility of the D-index is being investigated in clinical research. However, there are a few reports regarding the association between the D-index and the onset of opportunistic infection. We undertook this study to examine whether the D-index is useful to predict the onset of various infections in febrile neutropenia (FN) patients. Methods: The D-index was originally developed by Portugal et al. It is calculated as the area between <500 cells/μL and over the neutrophil curve when grade 4 neutropenia is present. We retrospectively investigated the events of febrile neutropenia among patients with acute myeloid leukemia (AML) treated at our institute. We recruited consecutive patients, younger than 65 years of age, newly diagnosed between November 1998 and February 2015. We collected all FN events from a chart review and evaluated the association between FN degree and infectious events. Survey periods covered the start of the induction chemotherapy to the end of the last consolidation therapy. Patients with a poor performance status (≥3) were excluded. We also calculated the total cumulative D-index (cD-index) from the first chemotherapy to the onset of FN, and the total D-index from the first chemotherapy to the last chemotherapy, to evaluate additive effects of the neutropenia. We tentatively determined the possible infection sites of the patients at the onset of FN in each event to analyze the presumable focus of infection. Results: In total, 35 cases and 122 FN events were enrolled (18 females and 17 males). The median age was 51 years (range, 18-65 years). The demography of FAB classification was M0, n = 1; M1, n = 5; M2, n = 14; M4, n = 3; M5, n = 3; M6, n = 2; and secondary AML, n = 7. Induction therapy consisted of idarubicin and Ara-C, and consolidation therapy consisted of high-dose Ara-C or rotated anthracyclines and Ara-C. The chemotherapy regimen was applied according to the JALSG AML201 or AML97 protocols. The response rate to induction chemotherapy was 60.0% (21/35), and 97.1% (34/35) of patients were alive at the end of follow-up. Only one patient died during chemotherapy; the cause of death was bacteremia due to Stenotrophomonas maltophilia (UNP 24). The total D-index was associated to the onset of infection with or without an identification of documented pathogens. However, high-dose Ara-C regimen and total D-index statistically significantly contributed to the onset of infection according to multivariate analysis (P = 0.0009 and 0.0205, respectively). Furthermore, the cD-index was a statistically significant contributing factor to predict the duration of FN according to multivariate analysis (P = 0.0378). Subsequently, we performed subgroup analysis and defined a significantly prolonged FN duration in the patients with respiratory focus compared with other focus sites. Conclusion: The total D-index was associated to the onset of infection during FN. However, the total D-index is a retrospective assessment index, calculated after neutropenic recovery. Therefore, the total D-index cannot be applicable to the prediction of infection upon FN. Our study identified respiratory foci of infection upon FN in the patients with high cD-index (≥5000) is a risk marker for the prolongation of FN. Then, we speculate that a respiratory manifestation at the onset of FN after consolidation therapy indicates a need for more intensive antimicrobial therapy. Disclosures No relevant conflicts of interest to declare.

scholarly journals Short remission durations in therapy-related leukemia despite cytogenetic complete responses to high-dose cytarabine

Blood ◽  
1988 ◽  
Vol 72 (4) ◽  
pp. 1333-1339
Author(s):  
RA Larson ◽  
M Wernli ◽  
MM Le Beau ◽  
KM Daly ◽  
LH Pape ◽  
...  
Keyword(s):  
Complete Remission ◽  
Chromosomal Abnormalities ◽  
Bone Marrow Cells ◽  
Performance Status ◽  
Single Agent ◽  
Poor Performance ◽  
High Response Rate ◽  
Poor Performance Status ◽  
High Dose ◽  
High Dose Cytarabine

Seventeen patients with therapy-related myelodysplastic syndrome (t- MDS) or therapy-related acute nonlymphocytic leukemia (t-ANLL) were treated with single-agent high-dose cytarabine (HDAC; 1 to 3 g/m2 every 12 hours for 12 doses). The initial neoplasm was still present in eight patients when t-MDS/t-ANLL developed. Fifteen of the 16 patients with chromosomal abnormalities in bone marrow cells had loss or rearrangement of chromosomes 5 and/or 7. One patient had a t(15;17), and one had inadequate material for cytogenetic analysis. Twelve patients had normal metaphase cells (3% to 71%). Indications for HDAC therapy were progressive pancytopenia in 13 patients or rising blast count in four. Five patients died of marrow hypoplasia following therapy. Four others had refractory t-ANLL and died within the subsequent 5 months. Only one of ten patients with a poor performance status (PS greater than or equal to 2 using the ECOG scale) achieved a complete remission, but all seven patients with a good performance status (PS less than or equal to 1) had a complete remission. Hematologic remissions were achieved in 8 patients (47%) after one (6 patients) or two (2 patients) induction courses and were confirmed by recovery of a 100% normal marrow karyotype in six of the seven patients who were retested. Patients in remission received one to four consolidation courses with HDAC alternating with cytarabine/doxorubicin, but seven relapsed within 8 months (median remission duration, 5 months). In every case, the original chromosomal abnormality reappeared at relapse. HDAC has a high response rate for good-performance patients with t-MDS/t-ANLL, but complete remissions are short even when confirmed cytogenetically and consolidated intensively.

Patients with Mature T-Cell Lymphoma Show High Relapse Rates after High Dose Therapy and Autologous Stem Cell Transplantation

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 774-774 ◽  
Author(s):  
Maike Nickelsen ◽  
Carmen Canals ◽  
Norbert Schmitz ◽  
Charalampia Kyriakou ◽  
Monika Engelhardt ◽  
...  
Keyword(s):  
Relative Risk ◽  
T Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
Large Cell ◽  
T Cell Lymphoma ◽  
Poor Performance Status ◽  
High Dose ◽  
Refractory Disease

Abstract Patients (pts) with mature (peripheral) T-cell lymphoma are known to have a poor prognosis when receiving standard conventional chemotherapy. This leads many physicians to regard high dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) as standard therapy for these pts. We here present a retrospective analysis on 424 pts with mature T-cell lymphoma who have received HDT and ASCT in EBMT centres between 2000 and 2005. Patients with primary cutaneous or immature (lymphoblastic) lymphoma were not included. Histological subtypes were anaplastic large cell lymphoma (ALCL, n=98, 23.1%; 19 anaplastic large cell kinase (ALK) positive, 42 ALK negative and for 37 pts the ALK status was unknown), peripheral T-cell lymphoma (PTCLu, n=176, 41.5%), angioimmunoblastic T-cell lymphoma (n=120, 28.3%) and aggressive T-cell lymphoma unspecified (n=30, 7.1%). Median age at ASCT was 51 years (17.2–73.5), median time from diagnosis to ASCT was 9 months (4–99), and median follow up for surviving pts was 36 months (0.4–99). 268 pts (63%) were male. 1/3 received HDT and ASCT after only one previous treatment line. 35% of the pts were treated in CR1, and 52% in chemosensitive disease worse than CR1. At the time point of ASCT only 12 pts (2.8%) had a poor performance status. 9% of the pts received total body irradiation as part of the conditioning regimen. At 3 years after ASCT non relapse mortality (NRM) was 7.4% and the relapse rate (RR) was 43.1%. In multivariate COX analysis for NRM refractory disease (p<0.001, relative risk 6.7) and poor performance status at ASCT (p=0.02, relative risk 3.2) were statistically significant adverse factors while the RR was significantly influenced by histology (PTCLu versus other subgroups, p=0.02, relative risk 1.4), and disease status at ASCT (refractory disease versus CR1 p=0.001, relative risk 3.3 and chemosensitive disease versus CR1 p=0.001, relative risk 1.9). At 3 years progression free survival (PFS) was 49.5% and overall survival (OS) 62.3%. In multivariate COX analysis adjusted for PFS refractory disease and chemosensitive disease worse than CR1 were significant adverse factors compared to CR1 (p<0.001 each, relative risk 3.2 and 1.7, respectively) as was refractory disease compared to chemosensitive disease (including CR1; p=0.004, relative risk 1.9). Other significant adverse factors were age at SCT 60 years (p=0.04, relative risk 1.4), poor performance status at ASCT (p=0.046, relative risk 2.1) and PTCLu versus other subgroups (p=0.02, relative risk 1.4). In summary there was a high RR for this group of pts who actually received ASCT. Especially refractory pts and pts in poor performance status did not benefit from the procedure. Further studies are necessary to better define the pts who will actually be cured by ASCT and to early identify the pts who will need other approaches and thus can be spared high dose chemotherapy which may negatively influence later salvage regimen.

scholarly journals Retrospective study of oxaliplatin, leucovarin and 5 fluoruracil regimen in patients with advanced gastric cancer with poor performance status: A study at a tertiary center of South India

2018 ◽  
Vol 07 (04) ◽  
pp. 223-225 ◽  
Author(s):  
Bhat Guruprasad
Keyword(s):  
Gastric Cancer ◽  
Retrospective Study ◽  
Advanced Gastric Cancer ◽  
South India ◽  
Performance Status ◽  
Locally Advanced ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Metastatic Setting ◽  
Tertiary Center

Abstract Background: Gastric carcinoma is the leading cause of cancer in south India. Gastric cancer is frequently diagnosed in locally advanced or metastatic setting in Indian scenario and has a poor survival. There is no standard chemotherapy regimen which can be used in advanced gastric cancer (AGC) patients. Objective: The aim of this study was to assess the clinical activity and toxicity of oxaliplatin with infusional 5-fluorouracil and leucovorin administered every 3 weeks in patients with locally advanced and inoperable gastric cancer. Patients and Methods: In this retrospective study, the case records of 25 patients who have received OLF regimen were analyzed. Results: The median number of cycles for patients was 6 (range: 4–12 cycles). Overall response rate was 36%, with all patients having stable disease. Median survival of patients was 6 months (7 months in locally advanced). Compared to other regimens, there was less toxicity (less hematologic toxicity, less nausea and vomiting, no hair loss, no renal toxicity, no hand foot syndrome, and lesser admissions). Conclusions: OLF regimen is an acceptable regimen in poor performance status AGC patients with adequate response and an acceptable toxicity profile.

Frequency of Allogeneic Stem Cell Transplant(SCT) in Patients Presenting with Newly-Diagnosed AML or AML at Time of First Salvage Therapy.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4332-4332
Author(s):  
Ravinder Sandhu ◽  
Stephen Petersdorf ◽  
Brenda M. Sandmaier ◽  
Paul O'Donnell ◽  
Pamela S. Becker ◽  
...  
Keyword(s):  
Salvage Therapy ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Age Distribution ◽  
Poor Performance ◽  
Initial Therapy ◽  
Poor Performance Status ◽  
Cell Transplant ◽  
Newly Diagnosed

Abstract Abstract 4332 Allogeneic SCT is widely considered the therapy most likely to prolong survival in pts with AML in first CR(CR1) or relapse (REL). Questions have arisen regarding the frequency with which the procedure is undertaken in a defined population of pts presenting with newly-diagnosed AML and subsequently followed through REL and after, or in pts presenting in REL. We first analyzed 26 consecutive UW pts age < 70 who did not have CBF AML, who were not NPM1+/FLT3,- and who achieved CR1 with at least 4 months have elapsing from presentation date. These patients would typically be considered candidates for SCT in CR1 Eleven of the 26(42%, 95% CI 23-63%) received SCT at a median of 3.5 months (range 0.5-9.0) from CR date. Rates of SCT were 42% both in pts age <60(8/19) and in pts ≥ 60 (3/ 7). In contrast to a report from another institute in which 14/99 pts age ≥50 received SCT in CR1 7/16 of the current pts did so (p=0.01). Rates of SCT were 6/13 in pts at highest risk based on cytogenetics and FLT3 status and 3/11 in pts at lower (i.e. “intermediate” risk; risk status not known in 2) Three of the 15 pts who did not receive SCT had available donors, but 12 were not HLA –typed. Age distribution was similar (p=0.31) in pts who were and were not HLA-typed and in only 2 non-typed pts were financial considerations or pt refusal an issue. Rather, notes suggested that physicians felt that pts were doing well and might not need SCT. We also examined our 21 consecutive pts who were under age 70, did not receive SCT in CR1, and were given first salvage therapy (S1) for relapse, again with at least 4 months follow-up from relapse date. These 21 included patients referred to us at initial diagnosis or only at time of S1. The frequency with which they were transplanted (8/21; 38% 95%CI 18-62%) did not differ from the frequency with which SCT was done in CR1. However SCT was most commonly done as 2nd salvage therapy (4 cases), with 3 pts transplanted in CR2 or CR and only 1 given SCT as S1.10 of the 13 S1 pts never given SCT had available donors (3 related, 3 unrelated, 4 cord) with SCT not done because of high blasts and/or poor performance status. We conclude that although older and younger pts may be equally likely to receive SCT in CR1, failure to HLA type may be a major impediment to increasing rates of SCT in CR1. Although relapsed pts are transplanted as often as pts in CR1, such transplants are only rarely used as initial therapy of relapse. Disclosures: No relevant conflicts of interest to declare.

Elderly Very Poor Performance Status Patients with Aggressive B Cell Lymphomas Can Gain Long Term Remissions with Intensive Chemotherapy with Encouraging Response Rates and Overall Survival (OS).

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2794-2794
Author(s):  
Stella J Bowcock ◽  
Vincenzo Fontana ◽  
Yvonne Noble ◽  
Susan Ward ◽  
Keith Winyard ◽  
...  
Keyword(s):  
B Cell ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Late Relapse ◽  
Poor Performance Status ◽  
Intensive Chemotherapy ◽  
B Cell Lymphomas ◽  
Curative Intent

Abstract Abstract 2794 Introduction Patients (pts) of older age, poor performance status (PS) and advanced stage with aggressive B cell lymphomas are regarded as poor prognosis and may receive no treatment, or palliative rather than curative chemotherapy. Studies suggest these pts may be undertreated and poor outcome may be partly related to undertreatment. Our unit has had a policy of offering treatment with curative intent to all pts presenting with aggressive B cell lymphomas, whatever their age or PS providing comorbidities allow. We reviewed the outcome of this policy. Methods All pts age≥70 years with diffuse large B cell lymphoma (DLBCL) or Burkitts lymphoma (BL) between 2000–2010 incl. were found from histology, chemotherapy and registry records. Poor PS pts were selected by including all who were inpatients during their 1st chemotherapy cycle, or if untreated, at diagnosis. If ECOG PS had not been prospectively recorded, ≥2 staff (from the 6 who were present throughout the 10 years) independently attributed status from memory and hospital notes. Only confirmed bedbound pts were designated PS4. Percentage chemotherapy doses delivered were calculated against the projected full dose and categorised into ≥85% Full, 60–85% RD, 30–60% HD. Pts receiving CHOP±R or CODOX-M/IVAC were called intensive (Int) and pts receiving low dose regimens called non-intensive (NI). Results 61 pts were found and 37 were inpatients. Of the 37 inpatients, 30 received chemotherapy, 29 for DLBCL and 1 for BL. Of the 30 treated pts (table 1) where parameters were assessable, LDH raised 92%, R-IPI ≥3 97%, PS 3/4 in 93%, stage3/4 86%, albumin <35g/l 70%. Of the 30 patients treated with chemotherapy, 18 achieved a CR with a median OS of 39 months(m) (range 8–123). There were 23 Int pts (9 were PS4, 7 of these being moribund), and 16 achieved CR median OS 48 m (range 12–99), 6 of them being PS4 and 4 were moribund. All pts achieving CR remained so except 1 late relapse (96m). Comorbidities were supported but did not influence treatment decisions except poor ejection fraction or dementia. (7 patients received no chemotherapy; declined ×3, cancer ×1, dementia ×1, not referred ×2) Discussion Our data show that very poor PS elderly pts can achieve CR (70%) with good OS with current intensive chemotherapy (CHOP±R, CODOX-M/IVAC±R). Further discussion refers to these pts (Int). CRs not only occurred in the PS2/3 pts, but also in 6/9 PS4 pts. The survivors could not be predicted and included 4 moribund pts. Toxicities were acceptable. Three of 4 moribund pts who survived received HD chemotherapy which was staggered due to emergency presentation. The 2nd cycle was given as soon as possible if improvement occurred (all responders did) with escalation of chemotherapy doses. This aggressive chemotherapeutic approach may have contributed to the good response rate. Our data show that putative toxicity is not a barrier to treatment with judicious dose reduction in the 1st cycle. Retrospective PS attribution was a weakness of the study. But objective parameters eg LDH, IPI, albumin and chemotherapy dose delivered concurred with the scores supporting their validity. PS4 criteria were objective. These data are important because they represent pts mostly excluded from trials. Recent data suggest that comorbidities may not influence survival. Our data support this. We suggest that elderly very poor PS pts can tolerate curative chemotherapy with encouraging remission rates and OS. Previous poor results may be due partly to undertreatment and most pts should be offered proper curative chemotherapy. A positive medical team attitude may be important. Disclosures: No relevant conflicts of interest to declare.

Rituximab Plus Bendamustin (R-B) Treatment In Patients with Aggressive Large B-Cell Lymphoma (LBCL): Response and Tolerability - a Single Institution Experience

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4900-4900
Author(s):  
Julia Horn ◽  
Martina Kleber ◽  
Ulrike Kohlweyer ◽  
Stefanie Hieke ◽  
Regina Herzog ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Performance Status ◽  
Progression Free Survival ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Poor Performance Status ◽  
First Line ◽  
Documentation System ◽  
Cd34 Cells ◽  
Grade Iii

Abstract Abstract 4900 Introduction: Clinical studies have shown that Rituximab plus Bendamustin (R-B) in indolent lymphoma results in favourable responses, progression free survival (PFS) and lower toxicity as compared to R-CHOP. The aim of this analysis was to characterize response and tolerability of R-B in patients with LBCL, who were not qualifying for R-CHOP due to age, comorbidity and/or prior pretreatment (including anthracyclines). Methods: We retrospectively identified consecutive patients with LBCL receiving at least two cycles of R-B in our department between 2003 and 2010 using our electronic tumor documentation system. Patient characteristics, response to R-B, and toxicity were assessed. Results: We identified 9 caucasian patients (5 females, 4 males) with LBCL; their median age was 71 years (range; 51–82). Two presented with stage I/II, seven with stage III/IV disease at initial diagnosis and before R-B. Six patients had a low or intermediate IPI and three were high risk. Four patients received R-B as first-line therapy, and five were treated for relapsed or refractory disease. Main determinants for the R-B-selection were contraindications for anthracyclines in five patients and advanced age and/or poor performance status in four patients. A median of four R-B-cycles were applied (range; 2–6). Response with achievement of CR and PR was observed in 6/9 (CR: 2, PR: 4), two achieved SD. Only one pt showed PD after four R-B cycles. The response of R-B in first-line vs. relapsed appeared similar. Of note, one female patient with secondary LCBL, after initial Hodgkin's lymphoma and C-MOPP chemotherapy (CTx) and mediastinal irradiation - with excellent response to R-B- failed to successfully mobilize PBSC thereafter. However, she was effectively mobilized with R-Ara-C-thiotepa (peripheral blood CD34+ cells were 5.82 vs. 54/μl, obtaining no vs. 6.72 × 106 CD34+ cells/kg KG via leukapheresis, respectively). Clinical tolerance of R-B in all patients was excellent in a total of 31 R-B-cycles, only two major CTC-events occurred: one infection (CTC grade III) and one thromboembolism (grade IV). Median PFS and overall Survival (OS) were 16 (7- not reached) and 20 (11-21) months. Conclusions: If standard R-CHOP cannot be given due to age, comorbidity or CTx-contraindications (e.g. anthracyclines), R-B may represent an effective treatment in LBCL. Larger cohorts and prospective clinical trials are needed to confirm these promising results. Currently, patients with grade III/IV follicular lymphoma are additionally evaluated for response and tolerability under R-B, also being presented at the meeting. Disclosures: No relevant conflicts of interest to declare.

Retrospective Observational Study on Multiple Myeloma Cases Admitted to Kfsh – Dammam Between 1st of June 2006 till the End of December 2013

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5995-5995
Author(s):  
Omar Zeid Abduljalil ◽  
Abid Mohiuddin ◽  
Hani Hassan Al Hashmi
Keyword(s):  
Multiple Myeloma ◽  
Observational Study ◽  
Patient Population ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
The United States ◽  
Response To Therapy ◽  
Poor Performance Status ◽  
High Dose ◽  
Primary Therapy

Abstract Introduction: Multiple myeloma (MM) is characterized by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. It accounts for approximately 1 percent of all cancers and slightly more than 10 percent of hematologic malignancies in the United States. There is a scarcity on the information of myeloma in the kingdom of Saudi Arabia.Hence was this observational study from a single center in Dammam, Saudi Arabia. . Method: Retrospective chart review of consecutive patients Diagnosed with Multiple myeloma in the period between 1st of May 2006 until end of December 2013 at King Fahd Specialist Hospital in Dammam (KFSHD). Purpose: to describe the presenting characteristics of MM patients in our region, treatment patterns prescribed with the outcome of therapy that include progression free survival and overall survival. Result: 63 patients with multiple myeloma were diagnosed and treated during this period. The percentage of patients with ECOG (≥2) is 52.3 % . 60 % of the patients had stage III international staging system (ISS). Only 17.4% received Triple agents as primary therapy as most of our patients received duplet therapy. 46% received High Dose therapy and Autologous stem cell transplantation. the PFS was 41.1 % and the OS of 69.1% at 95 months. Conclusion: Our results showed that we had rather younger patient population with a median age of 60 compared to the average western myeloma patient population. Despite the relatively young age those patients unfortunately had relatively poor performance status and high ISS stage which correlate with worse clinical outcome. However, the response to therapy and the outcome of our patients were superior to the outcome of any cohort of patients with similar disease characteristic. This observation worth further studying which could be due to an unknown disease or treatment related factors that might affect positively the patient’s outcome. Disclosures No relevant conflicts of interest to declare.

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