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Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age
- Source :
- Leukemia
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: ≤60 years (S1, n = 353), 61–65 years (S2, n = 107) and 66–70 years (S3, n = 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%, p = 0.05/p = 0.73), overall survival (log-rank p = 0.54) as well as time-to-progression (Gray’s p = 0.83) and non-relapse mortality (Gray’s p = 0.25), no differences were found between the three age groups. Our results imply that an intensive upfront therapy with a bortezomib-containing IT, MEL200/ASCT, lenalidomide consolidation, and maintenance should be applied to transplant-eligible MM patients up to 70 years of age.
- Subjects :
- Adult
Male
Melphalan
Cancer Research
medicine.medical_specialty
Multiple Myeloma/drug therapy
Medizin
Myeloma
Induction Chemotherapy/mortality
Article
Bortezomib
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Lenalidomide/administration & dosage
Humans
Medicine
Prospective Studies
Adverse effect
Lenalidomide
Multiple myeloma
Aged
Aged, 80 and over
business.industry
Correction
High dose melphalan
Consolidation Chemotherapy/mortality
Induction Chemotherapy
Hematology
Middle Aged
Prognosis
medicine.disease
Stem-cell research
Consolidation Chemotherapy
Survival Rate
Transplantation
Oncology
Toxicity
Randomized controlled trials
Bortezomib/administration & dosage
Female
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Multiple Myeloma
business
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 14765551 and 08876924
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Leukemia
- Accession number :
- edsair.doi.dedup.....abdfae6314551f474fd5c284e7f37463