Overall survival of transplant eligible patients with newly diagnosed multiple myeloma: comparative effectiveness analysis of modern induction regimens on outcome
Overall survival of transplant eligible patients with newly diagnosed multiple myeloma: comparative effectiveness analysis of modern induction regimens on outcome
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DOI：
10.1038/s41408-018-0163-7
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发表时间：
2018-12-11
影响因子：
12.8
通讯作者：
Rajkumar, S. Vincent
中科院分区：
文献类型：
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作者：
Paquin, Ashley R.;Kumar, Shaji K.;Rajkumar, S. Vincent
随着时间的推移，多发性骨髓瘤的总存活率(OS)有了显著的改善，最近的组间法语骨髓瘤(IFM)2009年随机试验报告称，接受现代治疗的患者的4年OS率约为82%。然而，临床试验的生存估计可能高估了临床实践中看到的结果，即使对年龄和其他关键特征进行了调整。这项研究的目的是确定在常规临床实践中看到的骨髓瘤患者的OS，这些患者与2009年IFM试验中研究的队列相似。第二个目标是对研究期间使用的硼替佐米、来那度胺、地塞米松和其他主要诱导方案进行简要的比较有效性分析。我们研究了2010年1月1日至2015年8月31日在梅奥诊所就诊的所有65岁及以下的骨髓瘤患者，他们在首次诊断后12个月内进行了干细胞采集。排除基线血肌酐为2 mg/dL的患者。对518例患者进行了研究。4年OS率为82.3%，与同期IFM随机试验的结果相当。标准骨髓瘤和高危骨髓瘤的4年生存率分别为86.3%和68.2%。
Overall survival (OS) of multiple myeloma has improved remarkably over time, with the recent Intergroupe Francophone du Myelome (IFM) 2009 randomized trial reporting a 4-year OS rate of approximately 82% in patients receiving modern therapy. However, survival estimates from clinical trials may overestimate outcomes seen in clinical practice even with the adjustment for age and other key characteristics. The purpose of this study was to determine the OS of myeloma patients seen in routine clinical practice who resembled the cohort studied in the IFM 2009 trial. A second goal was to conduct a brief comparative effectiveness analysis of bortezomib, lenalidomide, dexamethasone, and other major induction regimens used during the study period. We studied all patients with myeloma 65 years of age and younger, seen at the Mayo Clinic between January 1, 2010 and August 31, 2015, who had a stem cell harvest performed within 12 months of initial diagnosis. Patients with baseline serum creatinine >2 mg/dL were excluded. Five hundred and eighteen patients were studied. The 4-year OS rate was 82.3%, comparable to results achieved in the contemporaneous IFM randomized trial. The 4-year OS rates for standard and high-risk myeloma were 86.3% and 68.2%, respectively.