Defining cure in multiple myeloma: a comparative study of outcomes of young individuals with myeloma and curable hematologic malignancies.
Defining cure in multiple myeloma: a comparative study of outcomes of young individuals with myeloma and curable hematologic malignancies.
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DOI：
10.1038/s41408-018-0065-8
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发表时间：
2018-02-28
影响因子：
12.8
通讯作者：
Rajkumar SV
中科院分区：
文献类型：
--
作者：
Ravi P;Kumar SK;Cerhan JR;Maurer MJ;Dingli D;Ansell SM;Rajkumar SV
近年来治疗的进步使研究人员挑战多发性骨髓瘤（MM）无法治愈的教条。我们评估了年轻MM患者（≤50岁）的总体（OS）和无进展生存期（PFS），并比较了滤泡性淋巴瘤（FL）、弥漫性大b细胞淋巴瘤（DLBCL）和霍奇金淋巴瘤（HL）的预后。纳入2005年1月1日至2015年12月31日期间所有≤50岁的新诊断MM （n = 212）、FL （n = 168）、DLBCL （n = 195）和HL （n = 233）患者。通过标准化死亡率（SMR）总结观察期和预期期生存率。与美国背景人群相比，所有四种癌症诊断时的死亡风险均较高，MM的SMR为19.5 (15.2-24.5)，FL的SMR为4.2 (2.3-7.2)，DLBCL的SMR为13.0 (9.2-18.4)，HL的SMR为5.2（2.6-9.3）。我们推断，治愈最有可能发生在诊断后的前3年，并通过与背景人群相似的总体生存概率来反映。从36个月的里程碑来看，MM （SMR 20.7[14.7-28.3]）和FL （SMR 3.8[1.5-7.8]）的死亡风险较高，但DLBCL （SMR 3.1[0.8-8.0]）或HL （SMR 0.9[0.0-5.1]）的死亡风险较高。与诊断时和诊断后3年的背景人群相比，MM患者的死亡风险高出20倍，这表明MM仍然是一种无法治愈的癌症。
Advances in therapy in recent years have led investigators to challenge the dogma that multiple myeloma (MM) is incurable. We assessed overall (OS) and progression-free survival (PFS) of young patients ( ≤ 50 years) with MM and compared outcomes with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma (HL). All patients ≤ 50 years with newly diagnosed MM (n = 212), FL (n = 168), DLBCL (n = 195), and HL (n = 233) between 1 January 2005 and 31 December 2015 were included. Observed vs. expected survival was summarized by standardized mortality ratios (SMR). Compared to the background US population, excess mortality risk was seen at diagnosis in all four cancers, SMR 19.5 (15.2–24.5) in MM, 4.2 (2.3–7.2) in FL, 13.0 (9.2–18.4) in DLBCL, and 5.2 (2.6–9.3) in HL. We reasoned that cure would most likely occur in the first 3 years after diagnosis and be reflected by an overall survival probability similar to the background population. From the 36-month landmark, excess mortality risk was seen in MM (SMR 20.7 [14.7–28.3]) and FL (SMR 3.8 [1.5–7.8]), but not with DLBCL (SMR 3.1 [0.8–8.0]) or HL (SMR 0.9 [0.0–5.1]). MM patients have 20-fold excess mortality risk compared to the background population at diagnosis and at 3 years after diagnosis, suggesting that MM remains an incurable cancer.
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影响因子：
12.8
作者：
Maurer, Matthew J.;Bachy, Emmanuel;Ghesquieres, Herve;Ansell, Stephen M.;Nowakowski, Grzegorz S.;Thompson, Carrie A.;Inwards, David J.;Allmer, Cristine;Chassagne-Clement, Catherine;Nicolas-Virelizier, Emmanuelle;Sebban, Catherine;Lebras, Laure;Sarkozy, Clementine;Macon, William R.;Feldman, Andrew L.;Syrbu, Sergei I.;Traverse-Glehan, Alexandra;Coiffier, Bertrand;Slager, Susan L.;Weiner, George J.;Witzig, Thomas E.;Habermann, Thomas M.;Salles, Gilles;Cerhan, James R.;Link, Brian K.
通讯作者：
Link, Brian K.
影响因子：
158.5
作者：
Lonial, Sagar;Dimopoulos, Meletios;Richardson, Paul
通讯作者：
Richardson, Paul
影响因子：
45.3
作者：
Maurer, Matthew J.;Ghesquieres, Herve;Cerhan, James R.
通讯作者：
Cerhan, James R.
影响因子：
45.3
作者：
Barlogie, Bart;Attal, Michel;Harousseau, Jean-Luc
通讯作者：
Harousseau, Jean-Luc
影响因子：
20.3
作者：
Roschewski, Mark;Korde, Neha;Landgren, Ola
通讯作者：
Landgren, Ola