Szabo Agoston Gyula, Iversen Katrine Fladeland, Möller Sören, Plesner Torben
Department of Hematology, Vejle Hospital, Beriderbakken 4, 7100 Vejle, Denmark.
OPEN - Open Patient Data Explorative Network, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 9 A, 5000, Odense C, Denmark.
Clin Hematol Int. 2019 Aug 12;1(4):220-228. doi: 10.2991/chi.d.190805.002. eCollection 2019 Dec.
In this retrospective study we reviewed the clinical course of every patient with multiple myeloma treated from 2006 to 2016 at Vejle Hospital: 303 patients with a median age of 69 years at diagnosis received a median of four (range 1-18) lines of therapy; 149 in a 2006-2010 cohort and 154 in a 2011-2016 cohort. After initiation of treatment, the median decrease in the number of patients per each subsequent line of therapy was 22%. Lenalidomide-dexamethasone ( = 156), bortezomib-dexamethasone ( = 107), and bortezomib-lenalidomide-dexamethasone ( = 84) were the most commonly used regimens. The partial response or better rate was 78%, 58%, 55%, and 44% in lines of therapy one to four, respectively. The median (95% confidence interval [CI]) progression-free survival was 18 (15-22), 10 (8-13), 8 (7-10), and 6 (4-8) months in lines of therapy one to four, respectively. The median (95% CI) overall survival (OS) was 4.1 (3.7-4.8) years. Compared with the 2006-2010 cohort, patients in the 2011-2016 cohort had longer OS; 5.3 (4.7 to not reached) 3.4 (2.7-4.0) years, < 0.0001. This was especially true in patients not treated with high-dose therapy and autologous stem cell transplantation; 4.7 (3.2-5.9) 2.6 (2.0-3.3) years, = 0.0052. Patients in the 2011-2016 cohort were on treatment during a greater part of their life and had higher exposure to high-dose melphalan with autologous stem cell transplantation, lenalidomide, pomalidomide, daratumumab, and carfilzomib.
在这项回顾性研究中，我们回顾了2006年至2016年在维杰勒医院接受治疗的每例多发性骨髓瘤患者的临床病程：303例患者诊断时的中位年龄为69岁，接受的治疗线数中位数为4（范围1 - 18）；2006 - 2010队列中有149例，2011 - 2016队列中有154例。开始治疗后，每后续一线治疗的患者数量中位数减少22%。来那度胺 - 地塞米松（n = 156）、硼替佐米 - 地塞米松（n = 107）和硼替佐米 - 来那度胺 - 地塞米松（n = 84）是最常用的治疗方案。治疗一至四线的部分缓解或更好缓解率分别为78%、58%、55%和44%。治疗一至四线的中位（95%置信区间[CI]）无进展生存期分别为18（15 - 22）、10（8 - 13）、8（7 - 10）和6（4 - 8）个月。中位（95% CI）总生存期（OS）为4.1（3.7 - 4.8）年。与2006 - 2010队列相比，2011 - 2016队列中的患者OS更长；5.3（4.7至未达到）对3.4（2.7 - 4.0）年，P < 0.0001。在未接受大剂量治疗和自体干细胞移植的患者中尤其如此；4.7（3.2 - 5.9）对2.6（2.0 - 3.3）年，P = 0.0052。2011 - 2016队列中的患者在其生命的大部分时间接受治疗，并且接受大剂量美法仑联合自体干细胞移植、来那度胺、泊马度胺、达雷妥尤单抗和卡非佐米的暴露量更高。
