Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Int J Hematol. 2023 Nov;118(5):609-617. doi: 10.1007/s12185-023-03653-4. Epub 2023 Sep 5.
To investigate the real-world clinical outcomes and management of novel drug-containing therapies for newly diagnosed multiple myeloma (MM) patients, we retrospectively analyzed data on the first-line treatment for newly diagnosed transplant-ineligible MM patients from Kansai Myeloma Forum, a registry network in Japan. A total of 598 patients treated with novel drugs between March 2007 and February 2018 were analyzed. Regimens used were VD (n = 305), Rd (n = 103), VMP (n = 97), VCD (n = 71), and VRd (n = 22). Younger patients tended to receive VRd or VCD, whereas the regimen with the highest median patient age was Rd. More than three-quarters of patients in the Rd group received a reduced dose of lenalidomide. The Rd and VRd groups had a relatively high incidence of infection and skin complications, and the VMP group had the highest incidence of peripheral neuropathy. Overall response rate did not differ significantly between regimens. Multivariate analysis in all patients revealed several poor prognostic factors, such as poor performance status. Novel drug-containing regimens for newly diagnosed MM showed a durable response with manageable AEs in the real-world setting.
为了研究新型含药疗法在初诊多发性骨髓瘤(MM)患者中的真实世界临床结局和管理情况,我们对日本关西骨髓瘤论坛(Kansai Myeloma Forum)的登记网络中初诊不适合移植的 MM 患者一线治疗的数据进行了回顾性分析。共分析了 598 例 2007 年 3 月至 2018 年 2 月期间接受新型药物治疗的患者。所使用的方案包括 VD(n=305)、Rd(n=103)、VMP(n=97)、VCD(n=71)和 VRd(n=22)。年轻患者倾向于接受 VRd 或 VCD,而 Rd 方案的中位患者年龄最高。Rd 组中超过四分之三的患者接受了来那度胺的减量。Rd 和 VRd 组感染和皮肤并发症的发生率相对较高,而 VMP 组周围神经病的发生率最高。各方案之间的总体缓解率无显著差异。所有患者的多变量分析显示了一些不良预后因素,如较差的表现状态。在真实环境中,新型含药方案治疗初诊 MM 可获得持久缓解,且不良反应可管理。