功能对移植不合格多发性骨髓瘤患者初始治疗的影响
Yutaka Shimazu1,2, Junya Kanda3, Teruhito Takakuwa4
1Department of Hematology, Graduate School of Medicine, Kyoto University, 54, Kawaramachi, Shogoin, Sakyoku, Kyoto, 606-8507, Japan. yshimazu@kuhp.kyoto-u.ac.jp.
Annals of hematology
|August 21, 2024
概括
对于患有多发性骨髓瘤的功能障碍患者来说,治疗选择至关重要. 与RVd/D-Rd相比,像D-VMP/D-Vd这样的疗法可能提供更好的生存结果,特别是在功能受损的患者中.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 多发性骨髓瘤 (MM) 的预后有所改善,但功能障碍 (RI) 会使治疗复杂化,并使治疗结果恶化.
- 由于缺乏确定的标准,对不符合移植条件的MM患者的RI最佳初始治疗仍然不清楚.
研究的目的:
- 调查功能障碍 (RI) 对接受初始治疗的移植不合格多发性骨髓瘤 (MM) 患者的整体存活率 (OS) 的影响.
- 为了比较MM患者不同程度的功能不同治疗方案的有效性.
主要方法:
- 对349名有症状的MM患者 (年龄≥65,适合,移植不合格) 的回顾性分析.
- 分析的数据包括年龄,治疗方案 (RVd,D-VMP,D-Rd,D-Vd),国际分期系统 (ISS) 阶段,型,性能状态和估计的淋巴细胞过率 (eGFR <50 vs. ≥50 ml/min/1.73m2).
- 总体存活率 (OS) 根据这些因素和特定治疗方案进行评估.
主要成果:
- 多变量分析显示,ISS III阶段 (p=0.029) 和eGFR <50 (p<0.001) 的患者的生存寿命较短.
- 在EGFR<50.0的患者中,RVd/D-Rd疗程的OS显著较短.
- 在D-VMP/D-Vd疗法下的OS在EGFR<50和EGFR≥50.0的患者之间没有显著差异.
结论:
- 移植不合格的MM患者具有先进的ISS阶段和RI的预后不佳.
- 使用D-VMP或D-Vd方案的初始治疗可能不会受到功能障碍的影响,这表明这种患者群体的治疗选择可能更有利.
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