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Clinical impacts of frailty, poor performance status, and advanced age in carfilzomib-containing treatment for relapsed/refractory multiple myeloma: post hoc investigation of the KOTOSG multicenter pilot prospective observational study.
Kawaji-Kanayama, Yuka; Muramatsu, Ayako; Sasaki, Nana; Shimura, Kazuho; Kiyota, Miki; Fuchida, Shinichi; Isa, Reiko; Fujino, Takahiro; Matsumura-Kimoto, Yayoi; Tsukamoto, Taku; Chinen, Yoshiaki; Mizutani, Shinsuke; Nakao, Mitsushige; Kaneko, Hiroto; Kawata, Eri; Hirakawa, Koichi; Takahashi, Ryoichi; Shimazaki, Chihiro; Uchiyama, Hitoji; Uoshima, Nobuhiko; Shimura, Yuji; Kobayashi, Tsutomu; Taniwaki, Masafumi; Kuroda, Junya.
Afiliação
  • Kawaji-Kanayama Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Muramatsu A; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Sasaki N; Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
  • Shimura K; Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan.
  • Kiyota M; Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan.
  • Fuchida S; Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan.
  • Isa R; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Fujino T; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Matsumura-Kimoto Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Tsukamoto T; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Chinen Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Mizutani S; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Nakao M; Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan.
  • Kaneko H; Department of Hematology, Aiseikai Yamashina Hospital, Kyoto, Japan.
  • Kawata E; Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan.
  • Hirakawa K; Department of Hematology, Fukuchiyama City Hospital, Fukuchiyama, Japan.
  • Takahashi R; Department of Hematology, Omihachiman Community Medical Center, Omihachiman, Japan.
  • Shimazaki C; Department of Hematology, Japan Community Health Care Organization, Kyoto Kuramaguchi Medical Center, Kyoto, Japan.
  • Uchiyama H; Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
  • Uoshima N; Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
  • Shimura Y; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Kobayashi T; Department of Blood Transfusion, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Taniwaki M; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
  • Kuroda J; Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
Int J Hematol ; 115(3): 350-362, 2022 Mar.
Article em En | MEDLINE | ID: mdl-35072907
We conducted a post hoc analysis of our previous pilot observational study on the efficacy and safety of carfilzomib (CFZ)-containing therapy in 50 patients with relapsed/refractory multiple myeloma in routine practice to clarify the relationships between three major criteria for vulnerability (frailty, poor performance status [PS], and advanced age [≥ 75 years]) and their clinical impact on efficacy and adverse events (AEs). Sixteen patients fulfilled at least one and five patients fulfilled all three criteria. The overall response rate was not significantly affected by frailty, poor PS, and/or advanced age; however, frailty and advanced age were significantly associated with shorter progression-free survival (PFS). In contrast, no significant difference in PFS was observed between patients with PS0-1 or PS2-4. The three criteria for vulnerability were associated with more frequent hematologic AEs: frailty, poor PS, and/or advanced age significantly increased the risk of grade 3-4 anemia and lymphopenia. However, these criteria were not associated with increased risk of other non-hematologic AEs except infection. Collectively, these results demonstrate the need to carefully manage severe hematologic AEs in vulnerable patients and perform disease-specific assessment of frailty to predict prognosis.
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Texto completo: 1 Eixos temáticos: Pesquisa_clinica Base de dados: MEDLINE Assunto principal: Oligopeptídeos / Desempenho Psicomotor / Fragilidade / Mieloma Múltiplo / Antineoplásicos Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Eixos temáticos: Pesquisa_clinica Base de dados: MEDLINE Assunto principal: Oligopeptídeos / Desempenho Psicomotor / Fragilidade / Mieloma Múltiplo / Antineoplásicos Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2022 Tipo de documento: Article