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Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone

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Abstract
Abstract
We compared efficacy and safety, according to frailty, of elderly patients with relapsed and refractory multiple myeloma (RRMM) treated with lenalidomide and dexamethasone (Rd), for whom bortezomib treatment had failed. Patients, 164 (52.9%) and 146 (47.1%), were classified as non-frail and frail using a simplified frailty scale. The overall response rates (ORR) and survival outcomes were lower in frail than in non-frail patients (ORR: 56.2% vs. 67.7%, P = 0.069; median progression free survival: 13.17 vs. 17.80 months, P = 0.033; median overall survival: 23.00 vs. 36.27 months, P = 0.002, respectively). The number of treatment emergent adverse events in grade 3 or worse was higher in frail than in non-frail patients (41.8% vs. 24.4%, P = 0.002, respectively). In frail patients, independent poor prognostic factors for survival were two or more Charlson comorbidity index (CCI) score, prior to exposure to both bortezomib and thalidomide, and achieved less than partial response In conclusion, frailty could predict clinical outcomes of Rd treatment in elderly patients with RRMM who had failed prior bortezomib. In frail patients, lower CCI in addition to less previous treatment exposure and deep response were associated with better survival.
Author(s)
김기현김민경김성현김진석김효정도영록문영철민창기박승규박용방수미신호진엄현석윤덕현윤성수이원식이유진이재훈이제정이준호이호섭임성남조재철Mark Hong Lee
Issued Date
2021
Type
Article
Keyword
Elderly multiple myelomaFrailtyLenalidomide and dexamethasoneRelapsed and refractorySurvival
DOI
10.1007/s12185-020-02988-6
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8359
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_gale_infotracacademiconefile_A648597398&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Clinical%20impact%20of%20frailty%20on%20treatment%20outcomes%20of%20elderly%20patients%20with%20relapsed%20and%2For%20refractory%20multiple%20myeloma%20treated%20with%20lenalidomide%20plus%20dexamethasone&sortby=rank&pcAvailability=true
Publisher
INTERNATIONAL JOURNAL OF HEMATOLOGY
Location
일본
Language
영어
ISSN
0925-5710
Citation Volume
113
Citation Number
1
Citation Start Page
81
Citation End Page
91
Appears in Collections:
Medicine > Medicine
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