Renal Impairment at Diagnosis in Myeloma: Patient Characteristics, Treatment, and Impact on Outcomes. Results From the Australia and New Zealand Myeloma and Related Diseases Registry.
Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Australia
Bortezomib
/ administration & dosage
Child
Child, Preschool
Combined Modality Therapy
Dexamethasone
/ administration & dosage
Female
Follow-Up Studies
Glomerular Filtration Rate
Hematopoietic Stem Cell Transplantation
/ mortality
Humans
Infant
Male
Middle Aged
Multiple Myeloma
/ complications
Oligopeptides
/ administration & dosage
Prognosis
Prospective Studies
Registries
/ statistics & numerical data
Renal Insufficiency
/ etiology
Survival Rate
Transplantation, Autologous
Young Adult
Autologous
Multiple myeloma
Registry
Renal Impairment
Transplantation
Journal
Clinical lymphoma, myeloma & leukemia
ISSN: 2152-2669
Titre abrégé: Clin Lymphoma Myeloma Leuk
Pays: United States
ID NLM: 101525386
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
28
01
2019
revised:
14
04
2019
accepted:
12
05
2019
pubmed:
19
6
2019
medline:
7
8
2020
entrez:
19
6
2019
Statut:
ppublish
Résumé
Renal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies. We evaluated baseline characteristics, treatment, and outcomes of newly diagnosed MM patients with RI at diagnosis in the Australia and New Zealand Myeloma and Related Diseases Registry over 5 years to April 2018; we compared patients with RI (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m Overall, 36% of patients with newly diagnosed MM had RI; they were older, had more advanced disease and comorbidities, and worse performance status. Bortezomib-based induction therapy was most commonly used, although administered to fewer RI patients, despite similar response rates. Patients with RI were less likely to receive ASCT; however, recipients had longer progression-free survival (PFS) and overall survival (OS). Patients with RI had shorter OS and PFS after adjusting for age. In ASCT recipients with RI versus no RI, there was no difference in PFS and OS. Our findings in "real world" MM patients with RI confirm that patient-, disease-, and treatment-related factors (such as suboptimal bortezomib and ASCT use), and delays in commencing therapy, might contribute to poorer outcomes, and support the use of ASCT in patients with RI.
Sections du résumé
BACKGROUND
Renal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies.
PATIENTS AND METHODS
We evaluated baseline characteristics, treatment, and outcomes of newly diagnosed MM patients with RI at diagnosis in the Australia and New Zealand Myeloma and Related Diseases Registry over 5 years to April 2018; we compared patients with RI (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m
RESULTS
Overall, 36% of patients with newly diagnosed MM had RI; they were older, had more advanced disease and comorbidities, and worse performance status. Bortezomib-based induction therapy was most commonly used, although administered to fewer RI patients, despite similar response rates. Patients with RI were less likely to receive ASCT; however, recipients had longer progression-free survival (PFS) and overall survival (OS). Patients with RI had shorter OS and PFS after adjusting for age. In ASCT recipients with RI versus no RI, there was no difference in PFS and OS.
CONCLUSION
Our findings in "real world" MM patients with RI confirm that patient-, disease-, and treatment-related factors (such as suboptimal bortezomib and ASCT use), and delays in commencing therapy, might contribute to poorer outcomes, and support the use of ASCT in patients with RI.
Identifiants
pubmed: 31208889
pii: S2152-2650(19)30114-4
doi: 10.1016/j.clml.2019.05.010
pii:
doi:
Substances chimiques
Oligopeptides
0
Bortezomib
69G8BD63PP
carfilzomib
72X6E3J5AR
Dexamethasone
7S5I7G3JQL
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e415-e424Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.