Abstract |
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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Authors | Yuka Kawaji-Kanayama, Ayako Muramatsu, Nana Sasaki, Kazuho Shimura, Miki Kiyota, Shinichi Fuchida, Reiko Isa, Takahiro Fujino, Yayoi Matsumura-Kimoto, Taku Tsukamoto, Yoshiaki Chinen, Shinsuke Mizutani, Mitsushige Nakao, Hiroto Kaneko, Eri Kawata, Koichi Hirakawa, Ryoichi Takahashi, Chihiro Shimazaki, Hitoji Uchiyama, Nobuhiko Uoshima, Yuji Shimura, Tsutomu Kobayashi, Masafumi Taniwaki, Junya Kuroda, Kyoto Clinical Hematology Study Group (KOTOSG) Investigators |
Journal | International journal of hematology
(Int J Hematol)
Vol. 115
Issue 3
Pg. 350-362
(Mar 2022)
ISSN: 1865-3774 [Electronic] Japan |
PMID | 35072907
(Publication Type: Journal Article)
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Copyright | © 2022. Japanese Society of Hematology. |
Chemical References |
- Antineoplastic Agents
- Oligopeptides
- carfilzomib
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Topics |
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Antineoplastic Agents
(adverse effects, therapeutic use)
- Female
- Frailty
(etiology)
- Humans
- Male
- Middle Aged
- Multicenter Studies as Topic
- Multiple Myeloma
(drug therapy, mortality)
- Neoplasm Recurrence, Local
- Observational Studies as Topic
- Oligopeptides
(adverse effects, therapeutic use)
- Pilot Projects
- Prognosis
- Prospective Studies
- Psychomotor Performance
(drug effects)
- Risk
- Safety
- Survival Rate
- Treatment Outcome
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