Contributions
Abstract: EP1055
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
ASCT is still the standard of care for newly diagnosed patients with MM; however, it carries a high toxicity profile compared with chemotherapy or/and new agents such as thalidomide, lenalidomeide and anti-CD38.
Aims
the study aims to evaluate the treatment of newly diagnosed patients with MM using an intermittent therapy rather than autologous stem cell transplantation
Methods
The study was carried out at Al Bairouni University Cancer Center in Damascus, Syria between 2012 and 2017 and concluded 123 patients received three lines: (thalidomide+bortizomib+dexamethasone)/(lenalidomide+dexamethasone) and (bortizomib+dexamethasone), 44, 53 and 26 patients respectively. Evaluated evry 3 months and treatment was ceased in complete responders after 6 months of treatment and restarted upon documented relapse.
Results
Complete response was documented in 55 (44.7%) patients at the end of the 3rd month versus 102 (82.9%) at the end of 6th month. All patients relapsed or progressed at different times of treatment then they were retreated with the same induction or switched to another protocol. 112 patients were still alive at 5 years with an overall survival of 91%. In a univariate analysis, factors associated with poor survival are: patients with spinal cord compression at presentation with an odds ratio (OR) of 0.33 (95% CI, 0.11-0.83) and p value 0.04, extramedullary localization with an OR of 0.66 (95% CI, 0.15-0.95) and p value 0.09 and acute renal failure at presentation with an OR 4.5 (95% CI,0.9-9.7) and p value 0.004. The toxicity profile was acceptable.
Conclusion
Though all patients progressed or relapsed; however, 65 patients (52.8%) re-experienced the same complete response for at least four times using the same protocol, while the remaining 58 patients were responded at least 2 times then switched to other protocols in 3 occasions. Those with renal failure were correlated with poor survival taking into account the inability to deliver zoledronic acide. The toxicity profile was well tolerated and most patients continued their daily life with a good quality.
Results are comparable to those treated with ASCT taking into account the safe toxicity profile. Intermittent therapy is well tolerated, less aggressive and it had a better impact on the psychiatric status of the recruited cohort; however, a phase III head to head with ASCT is warranted in future.
Keyword(s): Multiple myeloma, Stem cell transplant, Treatment
Abstract: EP1055
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
ASCT is still the standard of care for newly diagnosed patients with MM; however, it carries a high toxicity profile compared with chemotherapy or/and new agents such as thalidomide, lenalidomeide and anti-CD38.
Aims
the study aims to evaluate the treatment of newly diagnosed patients with MM using an intermittent therapy rather than autologous stem cell transplantation
Methods
The study was carried out at Al Bairouni University Cancer Center in Damascus, Syria between 2012 and 2017 and concluded 123 patients received three lines: (thalidomide+bortizomib+dexamethasone)/(lenalidomide+dexamethasone) and (bortizomib+dexamethasone), 44, 53 and 26 patients respectively. Evaluated evry 3 months and treatment was ceased in complete responders after 6 months of treatment and restarted upon documented relapse.
Results
Complete response was documented in 55 (44.7%) patients at the end of the 3rd month versus 102 (82.9%) at the end of 6th month. All patients relapsed or progressed at different times of treatment then they were retreated with the same induction or switched to another protocol. 112 patients were still alive at 5 years with an overall survival of 91%. In a univariate analysis, factors associated with poor survival are: patients with spinal cord compression at presentation with an odds ratio (OR) of 0.33 (95% CI, 0.11-0.83) and p value 0.04, extramedullary localization with an OR of 0.66 (95% CI, 0.15-0.95) and p value 0.09 and acute renal failure at presentation with an OR 4.5 (95% CI,0.9-9.7) and p value 0.004. The toxicity profile was acceptable.
Conclusion
Though all patients progressed or relapsed; however, 65 patients (52.8%) re-experienced the same complete response for at least four times using the same protocol, while the remaining 58 patients were responded at least 2 times then switched to other protocols in 3 occasions. Those with renal failure were correlated with poor survival taking into account the inability to deliver zoledronic acide. The toxicity profile was well tolerated and most patients continued their daily life with a good quality.
Results are comparable to those treated with ASCT taking into account the safe toxicity profile. Intermittent therapy is well tolerated, less aggressive and it had a better impact on the psychiatric status of the recruited cohort; however, a phase III head to head with ASCT is warranted in future.
Keyword(s): Multiple myeloma, Stem cell transplant, Treatment