德国复发/难治性多发性骨髓瘤患者在干细胞移植前接受再诱导治疗的模式和结局。
Treatment pattern and outcomes of re-induction therapy prior to stem cell transplantation in patients with relapsed/refractory multiple myeloma in Germany.
机构信息
Department of Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany.
Medical Department, Hematology, Oncology & Stem Cell Transplantation, Faculty of Freiburg, Freiburg, Germany.
出版信息
Bone Marrow Transplant. 2024 Jun;59(6):880-889. doi: 10.1038/s41409-024-02208-3. Epub 2024 Mar 14.
There are limited data guiding choice of re-induction therapies for patients with relapsed/refractory multiple myeloma (RRMM) prior to stem cell transplantation (SCT). We performed a retrospective medical chart review of 171 patients with RRMM in Germany who received re-induction therapy in second line (78%; n = 134) or third line (22%; n = 37) prior to re-SCT. Index therapy was defined as first completed re-induction therapy for planned myeloablative conditioning and SCT in second/third line within the eligibility period (1/2016-12/2019). Most common pre-index first line and maintenance therapy used were bortezomib-based combinations (91%; n = 155/171) and lenalidomide (55%; n = 29/53), respectively. Median duration of index therapy line was 9 months; carfilzomib-based combinations were the most widely used in second/third line re-induction therapy (49%; n = 83/171), followed by daratumumab-based combinations (21%; n = 36/171). Overall response rates in second/third line were 87% after re-induction and 96% after SCT; median time to next treatment line after start of index therapy was 31 months; median progression-free survival (PFS) was 29 months; and median overall survival after index date was not reached. Based on these data, re-induction therapy with salvage SCT appears to be beneficial in selected patients with RRMM in clinical practice in Germany, translating into deep responses, long PFS and prolonged time to next treatment.
在接受干细胞移植 (SCT) 之前,复发/难治性多发性骨髓瘤 (RRMM) 患者的再诱导治疗选择的相关数据有限。我们对德国的 171 例 RRMM 患者进行了回顾性病历审查,这些患者在接受再 SCT 之前接受了二线 (78%;n=134) 或三线 (22%;n=37) 再诱导治疗。索引治疗定义为计划进行清髓性预处理和 SCT 的二线/三线中首次完成的诱导治疗,在合格期内 (1/2016-12/2019)。最常用的一线和维持治疗分别为硼替佐米为基础的联合治疗 (91%;n=155/171) 和来那度胺 (55%;n=29/53)。索引治疗线的中位持续时间为 9 个月;卡非佐米为基础的联合治疗在二线/三线再诱导治疗中应用最广泛 (49%;n=83/171),其次是达雷妥尤单抗为基础的联合治疗 (21%;n=36/171)。二线/三线再诱导后的总体缓解率为 87%,SCT 后的总体缓解率为 96%;索引治疗开始后到下一线治疗的中位时间为 31 个月;中位无进展生存期 (PFS) 为 29 个月;索引日期后未达到中位总生存期。根据这些数据,挽救性 SCT 的再诱导治疗在德国的 RRMM 患者中似乎是有益的,可带来深度缓解、较长的 PFS 和延长的下一次治疗时间。