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对达雷妥尤单抗、泊马度胺和地塞米松有反应的复发/难治性多发性骨髓瘤患者的不良血液学和非血液学事件

Adverse Hematological and Non-Hematological Events in Patients With Relapsed/Refractory Multiple Myeloma That Are Responsive to Daratumumab, Pomalidomide and Dexamethasone.

作者信息

Alkharabsheh Omar, Bellman Polina, Mahmoudjafari Zahra, Cui Wei, Atrash Shebli, Paul Barry, Hashmi Hamza, Shune Leyla, Ahmed Nausheen, Abdallah Al-Ola

机构信息

Division of Medical Oncology, University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA.

US Myeloma Innovations Research Collaborative (USMIRC), Westwood, KS, USA.

出版信息

J Hematol. 2023 Feb;12(1):1-6. doi: 10.14740/jh1085. Epub 2023 Feb 25.

Abstract

BACKGROUND

Daratumumab, pomalidomide, and dexamethasone (DPd) is an effective option for treatment of patients with relapsed/refractory multiple myeloma (RRMM). In this study, we sought to analyze the risk of hematological and non-hematological toxicities in patients who responded to DPd treatment.

METHODS

We analyzed 97 patients with RRMM who were treated with DPd between January 2015 and June 2022. The patients and disease characteristics, as well as safety and efficacy outcomes were summarized as descriptive analysis.

RESULTS

The overall response rate for the entire group was 74% (n = 72). The most common grade III/IV hematological toxicities in those who responded to treatment were neutropenia (79%), leukopenia (65%), lymphopenia (56%), anemia (18%), and thrombocytopenia (8%). The most common grade III/IV non-hematological toxicities were pneumonia (17%) and peripheral neuropathy (8%). The incidence of dose reduction/interruption was 76% (55/72), which was due to hematological toxicity in 73% of the cases. The most common reason for discontinuing treatment was disease progression in 61% (44 out of 72 patients).

CONCLUSIONS

Our study revealed that patients who respond to DPd are at high risk of dose reduction or treatment interruption because of hematological toxicity, typically due to neutropenia and leukopenia leading to increased risk of hospitalization and pneumonia.

摘要

背景

达雷妥尤单抗、泊马度胺和地塞米松(DPd)是治疗复发/难治性多发性骨髓瘤(RRMM)患者的有效选择。在本研究中,我们试图分析对DPd治疗有反应的患者发生血液学和非血液学毒性的风险。

方法

我们分析了2015年1月至2022年6月期间接受DPd治疗的97例RRMM患者。对患者和疾病特征以及安全性和疗效结果进行描述性分析总结。

结果

整个队列的总缓解率为74%(n = 72)。治疗有反应者中最常见的3/4级血液学毒性为中性粒细胞减少(79%)、白细胞减少(65%)、淋巴细胞减少(56%)、贫血(18%)和血小板减少(8%)。最常见的3/4级非血液学毒性为肺炎(17%)和周围神经病变(8%)。剂量减少/中断的发生率为76%(55/72),其中73%病例是由于血液学毒性。停止治疗的最常见原因是疾病进展,占61%(72例患者中有44例)。

结论

我们的研究表明,对DPd有反应的患者因血液学毒性而面临高剂量减少或治疗中断风险血液学毒性,通常是由于中性粒细胞减少和白细胞减少导致住院和肺炎风险增加。

相似文献

本文引用的文献

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Multiple myeloma: an overview of management.多发性骨髓瘤:治疗概述
Palliat Care Soc Pract. 2019 Oct 9;13:1178224219868235. doi: 10.1177/1178224219868235. eCollection 2019.

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