在临床研究之外接受治疗的老年人的临床结果:突出八十岁的经验
Dor Shpitzer1,2, Yael C Cohen1,2, Tamir Shragai1,2
1Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Blood advances
|March 6, 2025
概括
患有多发性骨髓瘤 (MM) 的八胞胎患者面临更多的并发症,导致治疗不那么密集,生存率更差. 然而,基于达拉图马布的疗法改善了结果,这表明针对性治疗对老年MM患者至关重要.
科学领域:
- 血液学 血液学 血液学
- 老年医学 老年医学
- 在瘤学瘤学.
背景情况:
- 多发性骨髓瘤 (MM) 越来越多地被诊断为八十岁以上的人 (年龄≥80岁).
- 关于MM管理和八十多岁人群的结果的数据有限,特别是在临床试验之外.
- 人口老龄化需要了解老年人的MM治疗差异.
研究的目的:
- 为了比较多发性骨髓瘤 (MM) 的八十岁人 (Octos) 与老年人 (OLs;年龄70-79岁) 的特征,治疗和结果.
- 确定影响老年MM患者治疗和生存的因素.
- 评估特定疗法的影响,如达拉图穆马布,对这一群体的结果.
主要方法:
- 追溯分析652名年龄≥70岁,在2014-2023年间被诊断患有活跃MM的患者.
- 在Octo和OL组之间比较患者人口统计学,并发症 (查尔森并发症指数 - CCI),治疗方案 (双倍与三倍/四倍),到下一次治疗的时间 (TTNT) 和整体存活率 (OS).
- 多变量分析以确定TTNT和OS的预测因素.
主要成果:
- 八代人群的CCI得分更高,并且接受的抗MM疗法不那么强烈,包括更少的三重/四重疗法.
- 与老年人相比,八代人体验的平均整体存活时间 (OS) 显著较短 (25.9 vs 71.3 个月).
- 三倍/四倍疗法改善了TTNT和OS;较高的CCI和80岁以上的年龄预测了更糟糕的OS;基于达拉图马布的疗法在两组中改善了TTNT.
结论:
- 八岁以上人群中较高的并发症负担会对MM的管理和生存产生不利影响.
- 强化治疗方案,特别是三倍/四倍疗法和达拉图巴,有望改善老年MM患者的治疗结果.
- 量身定制的治疗策略至关重要,以优化对患有多发性骨髓瘤的八岁老人的护理.
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