在多发性骨髓瘤中进行列纳利多米德维护的全国实施:一项回顾性,现实世界的研究
Mads Harsløf1,2, Iman Chanchiri3, Trine Silkjær4
1Department of Hematology Rigshospitalet Copenhagen Denmark.
EJHaem
|April 18, 2024
概括
在干细胞移植后,对多发性骨髓瘤 (MM) 进行莱纳利多米德维护 (LM) 是标准的. 丹麦的一项研究发现,与没有维持治疗相比,LM并没有改善无进展生存率或整体生存率.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 建议在高剂量梅尔法兰和自身干细胞移植 (HDM-ASCT) 后对新诊断的多发性骨髓瘤 (MM) 进行列纳利多米德维护 (LM).
- 在临床试验中,LM在无进展生存期 (PFS) 和整体生存期 (OS) 中显示出好处.
- 丹麦从2019年6月开始为所有HDM-ASCT患者提供公共资金LM.
研究的目的:
- 评估全国性莱纳利多米德维护 (LM) 对丹麦多发性骨髓瘤 (MM) 患者临床结果的现实影响.
- 为了比较MM患者的无进展生存 (PFS) 和整体生存 (OS),MM患者接受了LM,而不是历史对照.
主要方法:
- 在2019年6月至2022年3月期间接受HDM-ASCT治疗的364名新诊断的MM患者的回顾性分析,接受LM.
- 与364名MM患者的历史队列进行比较,这些患者在2015年6月至2019年6月期间接受了HDM-ASCT治疗,没有LM.
- 分析LM启动,停药率,停药原因 (毒性:疲劳,细胞衰减,神经病变) 和里程碑生存分析.
主要成果:
- 在接受LM的364名患者中,81.6%开始治疗,52.3%停止治疗,主要是由于毒性 (疲劳,细胞减小,神经病变).
- 在六个月的里程碑分析中,早期终止LM并没有对PFS或OS产生负面影响.
- 与LM前队列相比,LM队列显示了类似的3年PFS (61%对55%) 和OS (86%对89%) 与LM前队列相比.
结论:
- 丹麦将莱纳利多米德维护 (LM) 作为全国标准的护理,并没有显著改善HDM-ASCT后多发性骨髓瘤患者的临床结果 (PFS,OS).
- 毒性仍然是停止LM治疗的重要因素,影响了治疗的坚持.
- 可能需要进一步的研究来优化LM策略和管理毒性,以潜在地提高患者的治疗结果.
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