RESUMEN
Objective: This study aimed to evaluate the efficacy and safety of daratumumab as a maintenance treatment after autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with newly diagnosed multiple myeloma (NDMM) . Methods: The clinical data, hematological and renal response, and safety of 15 post-transplant patients with NDMM who had received daratumumab maintenance between May 1, 2022 and June 30, 2023 were retrospectively analyzed. Results: Fifteen patients (11 males and 4 females) with a median age of 58 (41-72) years were included. Thirteen patients did not receive daratumumab during induction therapy and auto-HSCT, 6 patients had renal impairment, and nine patients had high-risk cytogenetics. The median infusion of daratumumab was 12 (6-17) times, and the median duration of maintenance was 6 (1.5-12) months. The treatment efficacy was evaluated in all 15 patients, and daratumumab maintenance therapy increased the rate of stringent complete response from 40% to 60%. The renal response rate and median estimated glomerular filtration rate of six patients with RI-NDMM were also improved. During daratumumab maintenance therapy, the most common hematological grade 3 adverse event (AE) was lymphopenia [4 of 15 patients (26.67%) ], whereas the most common nonhematologic AEs were infusion-related reactions [7 of 15 patients (46.67%) ] and grade 3 pneumonia [5 of 15 patients (33.33%) ]. The five patients with pneumonia were daratumumab naive [5 of 13 patients (38.46%) ], with a median of 8 (6-10) infusions. Among them, the chest computed tomography of three patients showed interstitial infiltrates, and treatment with methylprednisolone was effective. With a median follow-up of 12 months, the 1-year overall survival rate was 93.33%, and only one patient died (which was not related to daratumumab treatment) . Conclusions: Daratumumab was safe and effective as a maintenance agent for post-auto-HSCT patients with NDMM, and AEs were controllable. The most common nonhematologic AE was grade 3 pneumonia, and a less dose-intense maintenance regimen for the first 8 weeks could reduce the incidence of pneumonia.
Asunto(s)
Anticuerpos Monoclonales , Trasplante de Células Madre Hematopoyéticas , Mieloma Múltiple , Neumonía , Masculino , Femenino , Humanos , Persona de Mediana Edad , Anciano , Mieloma Múltiple/tratamiento farmacológico , Estudios Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Trasplante Autólogo , Neumonía/etiología , Dexametasona , Bortezomib/uso terapéuticoRESUMEN
Sixteen patients with carcinoma of the upper neck esophagus were treated by total esophagectomy and replacement with transverse colon in this hospital from 1982 to 1989. The operative morbidity rate was 18.7% and no death occurred. There were 8 patients with lesion longer than 5 cm, 3 less than 3 cm, and 5 between 3 cm and 5 cm. The length between the tumor and the proximal margin of resection was less than 2 cm in 5 patients, between 2 and 4 cm in 8, and more than 4 cm in 3. No residual tumor was found pathologically at stumps. Follow-up study showed that 5 patients survived more than 5 years, 5 patients 3 to 5 years, 6 patients less than 3 years. The maneuver and advantages of the operation were introduced and the problems concerning the prevention of operative complication were investigated.