Impact of dexamethasone responsiveness on long term outcome in patients with newly diagnosed multiple myeloma.
Impact of dexamethasone responsiveness on long term outcome in patients with newly diagnosed multiple myeloma.
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DOI：
10.1111/j.1365-2141.2009.08023.x
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发表时间：
2010-03
影响因子：
6.5
通讯作者：
Kumar S
中科院分区：
文献类型：
--
作者：
Sinha S;Rajkumar SV;Lacy MQ;Hayman SR;Buadi FK;Dispenzieri A;Dingli D;Kyle RA;Gertz MA;Kumar S
地塞米松 (Dex) 单独或联合使用通常用于治疗多发性骨髓瘤。 Dex 作为骨髓瘤初始治疗的单一药物，总体缓解率为 50-60%。目前尚不清楚类固醇反应性是否反映了影响长期结果的任何生物学特征。我们研究了 1998 年 3 月至 2007 年 6 月期间新诊断的 182 名骨髓瘤患者的队列，这些患者最初接受单药 Dex 治疗至少 4 周。诊断时的中位年龄为 63 岁（范围为 39-81 岁），中位估计生存期为 55 个月。在中位治疗持续时间为 15 周时，91 名（50%）患者出现部分缓解或更好，80 名（44%）患者低于部分缓解，其余（6%）患者无法评估。应答者诊断后的中位总生存期为 75 个月，而其余患者为 71 个月，p=0.6。基线疾病特征和 Dex 反应性之间不存在相关性。虽然接受自体干细胞移植的 130 名患者 (70%) 的总生存期更长，但两组中的生存率和 Dex 反应性之间均未发现相关性。在这组骨髓瘤患者中，对单药类固醇没有反应并没有对最终结果产生不利影响。
Dexamethasone (Dex), alone or in combination, is commonly used for treating multiple myeloma. Dex as single agent for initial therapy of myeloma results in overall response rates of 50-60%. It is unclear whether steroid responsiveness reflects any biological characteristic that impacts long-term outcome. We studied a cohort of 182 patients with newly diagnosed myeloma seen between March 1998 and June 2007, initially treated with single-agent Dex for at least 4 weeks. The median age at diagnosis was 63 years (range, 39-81) and the median estimated survival was 55 months. At a median duration of therapy of 15 weeks, 91(50%) patients had a partial response or better, 80 (44%) had less than partial response and the remaining (6%) patients were not evaluable. The median overall survival from diagnosis for the responders was 75 months compared to 71 months for remaining patients, p=0.6. There was no correlation between baseline disease characteristics and Dex responsiveness. While overall survival was longer for the 130 (70%) patients who proceeded to an autologous stem cell transplant, no correlation was found between survival and Dex responsiveness among either group. Among this cohort of patients with myeloma, failure to respond to single agent steroid did not have an adverse impact on eventual outcome.
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影响因子：
39.2
作者：
ALEXANIAN, R;BARLOGIE, B;DIXON, D
通讯作者：
DIXON, D
影响因子：
11.4
作者：
Durie, B. G. M.;Harousseau, J-L;Rajkumar, S. V.
通讯作者：
Rajkumar, S. V.
影响因子：
8.9
作者：
Kyle, RA;Gertz, MA;Greipp, PR
通讯作者：
Greipp, PR
影响因子：
4.8
作者：
Kumar, S;Lacy, MQ;Gertz, MA
通讯作者：
Gertz, MA
影响因子：
20.3
作者：
Brenner, Hermann;Gondos, Adam;Pulte, Dianne
通讯作者：
Pulte, Dianne