Treatment Outcomes in Patients With Newly Diagnosed Multiple Myeloma Who Are Ineligible for Stem-Cell Transplantation: Systematic Review and Network Meta-analysis
Publication date: Available online 29 April 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Yaohua Cao, Ning Wan, Zhuoru Liang, Jingmei Xie, Sen Wang, Tengfei Lin, Tiantian Zhang, Jie JiangAbstractMany new regimens have been applied to newly diagnosed transplant-ineligible multiple myeloma, but no head-to-head research has been performed to compare the efficacy of these treatments. Currently lenalidomide plus dexamethasone (Rd) is one of the standard treatments. Our aim was to make a comparison of these treatments to Rd by a network meta-analysis. We performed a systematic review and network meta-analysis. We searched PubMed, Embase, and the Cochrane Library for articles published from January 1, 1988, to April 26, 2018, as well as research presented at 5 international conferences (American Society of Clinical Oncology, American Society of Hematology, European Hematology Association, European Society of Medical Oncology, and International Myeloma Working Group) between January 2015 and December 2018. Our interest outcomes were hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS). Bayesian fixed-effects mixed-treatment comparisons were used for this study. A total of 23 articles describing 10,401 participants were included for this network meta-analysis. Lenalidomide and dexamethasone plus daratumumab (HR, 0.57; 95% credible interval [CrI], 0.43-0.73), daratumumab plus bortezomib, melphalan, and prednisone (HR, 0.59; 95% CrI, 0.36-0.91...
ConclusionmCBAD results in high response rates in myeloma and PCL, however, with high treatment-related mortality. Its use in RRMM should be limited to patients who have immediate need for therapy without other treatment options and who have good performance status (score of 0-1) or NDMM if novel agents are not available depending on practice setting. mCBAD can be a treatment option for patients with PCL.
ConclusionThese outcomes suggest that TMZ may have activity for maintenance in elderly patients with PCNSL, when more aggressive treatments are contraindicated.
Condition: Leukemia, Lymphoma, Multiple Myeloma Intervention: Behavioral: coping skills training Sponsor: Duke University Not yet recruiting
ConclusionmCBAD results in high response rates in myeloma and PCL, however with high treatment-related mortality. Its use in RRMM should be limited to patients who have immediate need for therapy without other treatment options who have good PS (PS 0-1) or NDMM if novel agents are not available depending on practice setting. mCBAD can be a treatment option for patients with PCL.
Publication date: Available online 16 May 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): P Joy Ho, Elizabeth M. Moore, Zoe K. McQuilten, Cameron Wellard, Krystal Bergin, Bradley Augustson, Hilary Blacklock, Simon J. Harrison, Noemi Horvath, Tracy King, Peter Mollee, Hang Quach, Christopher Reid, Brian Rosengarten, Patricia Walker, Erica M. Wood, Andrew SpencerAbstractBackgroundRenal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies.Patients and MethodsWe evaluated baseline characteristics, treatment and outcome...
ConclusionThe existing data on TMS is limited and most of the data is based on the experience involving the more common sites. Uncommon sites like testes have not been explored much due to rarity of disease and lack of any controlled trials. As per the current literature, combined chemotherapy regimen followed by HSCT has the best outcome.
Renal impairment (RI) is common in multiple myeloma (MM) and is associated with poor prognosis. The Australia and New Zealand Myeloma Registry was used to assess>1000 newly diagnosed MM patients, of whom 383 had RI at diagnosis. Patients who underwent autologous stem cell transplant (ASCT) despite RI had improved survival; potential factors for an inferior outcome include suboptimal use of bortezomib and ASCT.