Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group
Abstract
:1. Introduction
2. Material and Methods
2.1. Patients Characteristics
2.2. Treatment Regimens
2.3. Treatment Response and Toxicity Assessment
2.4. Statistical Analysis
3. Results
3.1. Response to Treatment
3.2. Progression-Free Survival
3.3. Overall Survival
3.4. Patients with High-Risk Cytogenetics
3.5. Toxicity and Tolerability of Bendamustine-Based Therapies
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients | Bendamustine + Steroid | Bendamustine + Steroid + Thal/Len/Bort | |
---|---|---|---|
n = 105 | n = 52 | n = 53 | |
Sex | |||
male | 50 (48%) | 24 (46%) | 26 (49%) |
female | 55 (52%) | 28 (54%) | 27 (51%) |
Age | |||
median (range) | 64 (45–84) | 64 (45–82) | 65 (49–84) |
>65 years | 43 (41%) | 22 (42%) | 21 (40%) |
Monoclonal protein type | |||
IgG | 68 (65%) | 35 (67%) | 33 (62%) |
IgA | 25 (24%) | 12 (23%) | 13 (25%) |
LCD | 12 (11%) | 5 (10%) | 7 (13%) |
Light chain | |||
kappa | 61 (58%) | 31 (60%) | 30 (57%) |
lambda | 44 (42%) | 21 (40%) | 23 (43%) |
ISS stage | |||
I | 20 (19%) | 11 (21%) | 9 (17%) |
II | 31 (30%) | 16 (31%) | 15 (28%) |
III | 54 (51%) | 25 (48%) | 29 (55%) |
Cytogenetics | |||
unknown | 84 (80%) | 43 (83%) | 41 (77%) |
del(17p13) | 5 (24%) 1 | 3 (33%) 1 | 2 (17%) 1 |
del(13q14) | 3 (14%) 1 | 1 (11%) 1 | 2 (17%) 1 |
t(4;14)(p16;q32) | 4 (19%) 1 | 1 (11%) 1 | 3 (25%) 1 |
t(14;16)(q32;q23) | 1 (5%) 1 | 1 (11%) 1 | 0 (0%) 1 |
Serum monoclonal protein | 23.9 (0.87–95.6) | 22.7 (0.87–95.6) | 25.2 (1.37–84.56) |
(g/L; median, range) | |||
Bone marrow plasma cells | 46.5 (7–90) | 48.0 (10–90) | 42.5 (7–85) |
(%; median, range) | |||
Albumin | 3.6 (2.01–5.33) | 3.6 (2.01–5.33) | 3.6 (2.01–5.33) |
(g/dL; median, range) | |||
Beta-2-microglobulin | 4.93 (1.1–40) | 4.65 (2.5–36) | 5.11 (1.1–40) |
(mg/L; median, range) | |||
LDH | 211 (75–2205) | 238 (75–1872) | 281 (107–2205) |
(IU/L; median, range) | |||
Creatinine | 0.965 (0.4–9.33) | 1.053 (0.64–7.83) | 0.924 (0.4–9.33) |
(mg/dL; median, range) | |||
eGFR | 69 (5.37–185.9) | 68 (5.37–152.7) | 71 (9.5–185.9) |
(mL/min; median, range) | |||
Calcium | 2.37 (1.79–4.94) | 2.45 (2.08–4.94) | 2.29 (1.79–4.63) |
(mmol/L; median, range) | |||
Neutrophils | 3.08 (0.59–8.87) | 3.42 (1.15–8.87) | 2.84 (0.59–7.59) |
(G/L; median, range) | |||
Hemoglobin | 10.25 (6.6–14.7) | 10.13 (6.6–14.7) | 10.37 (6.9–13.6) |
(g/dL; median, range) | |||
Platelets | 159 (22–409) | 149 (22–378) | 161 (29–409) |
(G/L; median, range) | |||
Previous treatment | |||
Number of lines (median, range) | 3 (1–8) | 3 (1–8) | 3 (1–6) |
IMID | 100 (95%) | 51(98%) | 49 (92%) |
Thalidomide | 93 (89%) | 48 (92%) | 45 (85%) |
Lenalidomide | 56 (53%) | 38 (73%) 2 | 18 (34%) 2 |
PI | 92 (88%) | 48 (92%) | 44 (83%) |
Bortezomib | 83 (79%) | 45 (87%) | 38 (72%) |
Carfilzomib | 9 (9%) | 3 (6%) | 5 (9%) |
Lenalidomide + Bortezomib | 51 (49%) | 37 (71%) 2 | 14 (26%) 2 |
IMID + PI | 91 (87%) | 47 (90%) | 44 (83%) |
ASCT | 33 (31%) | 16 (31%) | 17 (32%) |
All Patients n = 105 | Bendamustine + Steroid n = 52 | Bendamustine + Steroid + Thal/Len/Bort n = 53 | |
---|---|---|---|
ORR | 48 (46%) | 19 (37%) | 29 (55%) |
CR | 8 (8%) | 1 (2%) * | 7 (13%) * |
VGPR | 9 (9%) | 3 (6%) | 6 (11%) |
CR + VGPR | 17 (16%) | 4 (8%) * | 13 (25%) * |
PR | 31 (30%) | 15 (29%) | 16 (30%) |
SD | 37 (35%) | 24 (46%) | 13 (25%) |
PD | 20 (19%) | 9 (17%) | 11 (21%) |
Bendamustine + Steroid n = 52 | Bendamustine + Steroid + Len/Thal/Bort n = 53 | |||
---|---|---|---|---|
All grades | Grade ≥3 | All grades | Grade ≥3 | |
Neutropenia | 28 (54%) | 15 (29%) | 32 (60%) | 25 (47%) |
Anemia | 18 (35%) | 11 (21%) | 21 (40%) | 6 (11%) |
Thrombocytopenia | 17 (33%) | 10 (19%) | 15 (28%) | 10 (19%) |
Infection | 27 (52%) | 10 (19%) | 20 (38%) | 5 (11%) |
Gastrointestinal toxicity | 5 (10%) | 0 (0%) | 3 (7%) | 2 (4%) |
Thromboembolism | 1 (2%) | 1 (2%) | 2 (4%) | 1 (2%) |
Neuropathy | 0 (0%) | 0 (0%) | 1 (2%) | 0 (0%) |
Renal function impairment | 2 (4%) | 0 (0%) | 1 (2%) | 0 (0%) |
Hepatic toxisity | 0 (0%) | 0 (0%) | 1 (2%) | 0 (0%) |
Hypertension | 1 (2%) | 1 (2%) | 0 (0%) | 0 (0%) |
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Grzasko, N.; Charlinski, G.; Morawska, M.; Kicinski, P.; Waszczuk-Gajda, A.; Drozd-Sokolowska, J.; Subocz, E.; Blonska, D.; Razny, M.; Druzd-Sitek, A.; et al. Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group. J. Clin. Med. 2021, 10, 5504. https://doi.org/10.3390/jcm10235504
Grzasko N, Charlinski G, Morawska M, Kicinski P, Waszczuk-Gajda A, Drozd-Sokolowska J, Subocz E, Blonska D, Razny M, Druzd-Sitek A, et al. Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group. Journal of Clinical Medicine. 2021; 10(23):5504. https://doi.org/10.3390/jcm10235504
Chicago/Turabian StyleGrzasko, Norbert, Grzegorz Charlinski, Marta Morawska, Pawel Kicinski, Anna Waszczuk-Gajda, Joanna Drozd-Sokolowska, Edyta Subocz, Danuta Blonska, Malgorzata Razny, Agnieszka Druzd-Sitek, and et al. 2021. "Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group" Journal of Clinical Medicine 10, no. 23: 5504. https://doi.org/10.3390/jcm10235504