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硼替佐米-来那度胺-地塞米松诱导治疗对新诊断多发性骨髓瘤伴肾功能损害患者的影响:来自 Connect® MM 登记研究的结果。

Impact of lenalidomide-bortezomib-dexamethasone induction on patients with newly diagnosed multiple myeloma and renal impairment: Results from the Connect® MM Registry.

机构信息

Mayo Clinic, Jacksonville, FL, USA.

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Blood Cancer J. 2024 Nov 11;14(1):198. doi: 10.1038/s41408-024-01177-6.

Abstract

Limited data exist on the effects of induction treatment in patients with newly diagnosed multiple myeloma (NDMM) and renal impairment (RI), who may also be ineligible for autologous stem cell transplant. This analysis investigated the impact of lenalidomide-bortezomib-dexamethasone (RVd) induction on renal function in patients from the Connect® MM Registry based on transplant status. Eligible patients were aged ≥18 years with symptomatic MM diagnosed ≤2 months before enrollment. Patients in this analysis received front-line RVd for ≥3 cycles and were grouped by transplant status and baseline renal function. As of August 4, 2021, 344 transplanted and 289 non-transplanted patients had received RVd for ≥3 cycles at induction. Improved renal function was observed at 3, 6, and 12 months in patients with all severities of RI at baseline. In patients with >60 and ≤60 creatinine clearance mL/min at baseline, median progression-free survival was 49.4 months and 47.6 months in transplanted patients and 35.7 months and 29.1 months in non-transplanted patients, respectively. These results provide real-world evidence that patients with NDMM and RI who receive front-line RVd for ≥3 cycles may have improved renal function regardless of transplant status, with renal function no longer affecting the long-term outcome. Clinical trial information: NCT01081028.

摘要

关于新诊断多发性骨髓瘤(NDMM)和肾功能损害(RI)患者的诱导治疗效果的数据有限,这些患者可能也不符合自体干细胞移植的条件。本分析根据移植状态,调查了 Connect® MM 登记处的患者中,来那度胺-硼替佐米-地塞米松(RVd)诱导治疗对肾功能的影响。符合条件的患者年龄≥18 岁,在入组前 2 个月内确诊为有症状的 MM。本分析中,患者接受了至少 3 个周期的一线 RVd 治疗,并根据移植状态和基线肾功能进行了分组。截至 2021 年 8 月 4 日,344 例接受移植和 289 例未接受移植的患者接受了至少 3 个周期的 RVd 诱导治疗。在基线时存在所有严重程度 RI 的患者中,在第 3、6 和 12 个月观察到肾功能改善。在基线时肌酐清除率>60 和≤60 mL/min 的患者中,移植患者的中位无进展生存期分别为 49.4 个月和 47.6 个月,未移植患者分别为 35.7 个月和 29.1 个月。这些结果提供了真实世界的证据,表明接受至少 3 个周期一线 RVd 治疗的 NDMM 和 RI 患者可能会改善肾功能,无论移植状态如何,肾功能不再影响长期结局。临床试验信息:NCT01081028。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6873/11554676/71e89040049d/41408_2024_1177_Fig1_HTML.jpg

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