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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

Authors
 Ho Sup Lee  ;  Kihyun Kim  ;  Je-Jung Lee  ;  Sung-Soo Yoon  ;  Soo-Mee Bang  ;  Jin Seok Kim  ;  Hyeon-Seok Eom  ;  Dok Hyun Yoon  ;  Yoojin Lee  ;  Ho-Jin Shin  ;  Yong Park  ;  Jae-Cheol Jo  ;  Won Sik Lee  ;  Young Rok Do  ;  Yeung-Chul Mun  ;  Mark Hong Lee  ;  Hyo Jung Kim  ;  Sung-Hyun Kim  ;  Min Kyoung Kim  ;  Sung-Nam Lim  ;  Seong Kyu Park  ;  Jun Ho Yi  ;  Jae Hoon Lee  ;  Chang-Ki Min 
Citation
 INTERNATIONAL JOURNAL OF HEMATOLOGY, Vol.113(1) : 81-91, 2021-01 
Journal Title
INTERNATIONAL JOURNAL OF HEMATOLOGY
ISSN
 0925-5710 
Issue Date
2021-01
MeSH
Aged ; Aged, 80 and over ; Bortezomib / adverse effects ; Dexamethasone / administration & dosage* ; Dexamethasone / adverse effects ; Disease-Free Survival ; Drug Therapy, Combination ; Female ; Frailty / etiology* ; Humans ; Lenalidomide / administration & dosage* ; Lenalidomide / adverse effects ; Male ; Middle Aged ; Multiple Myeloma / drug therapy* ; Multiple Myeloma / mortality ; Recurrence ; Treatment Failure ; Treatment Outcome
Keywords
Elderly multiple myeloma ; Frailty ; Lenalidomide and dexamethasone ; Relapsed and refractory ; Survival
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.
Full Text
https://link.springer.com/article/10.1007/s12185-020-02988-6
DOI
10.1007/s12185-020-02988-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191083
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