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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

Title
Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone
Authors
Lee H.S.Kim K.Lee J.-J.Yoon S.-S.Bang S.-M.Kim J.S.Eom H.-S.Yoon D.H.Lee Y.Shin H.-J.Park Y.Jo J.-C.Lee W.S.Do Y.R.Mun Y.-C.Lee M.H.Kim H.J.Kim S.-H.Kim M.K.Lim S.-N.Park S.K.Yi J.H.Lee J.H.Min C.-K.The Korean Multiple Myeloma Working Party (KMMWP)
Ewha Authors
문영철
SCOPUS Author ID
문영철scopus
Issue Date
2021
Journal Title
International Journal of Hematology
ISSN
0925-5710JCR Link
Citation
International Journal of Hematology vol. 113, no. 1, pp. 81 - 91
Keywords
Elderly multiple myelomaFrailtyLenalidomide and dexamethasoneRelapsed and refractorySurvival
Publisher
Springer Japan
Indexed
SCIE; SCOPUS scopus
Document Type
Article
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. © 2020, Japanese Society of Hematology.
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DOI
10.1007/s12185-020-02988-6
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의과대학 > 의학과 > Journal papers
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