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Abdrabou AK, Sharif FA, Fakih RE, Hashmi S, Khafaga YM, Alhayli S, Zahrani HA, Ahmed S, Fraih FA, Shaheen M, Rasheed W, Chaudhri NA, Mohareb FA, Khalil H, Aljurf M, Hanbali A. Outcomes of autologous stem cell transplantation for multiple myeloma in Saudi Arabia. Ann Saudi Med 2021; 41:198-205. [PMID: 34420396 PMCID: PMC8380276 DOI: 10.5144/0256-4947.2021.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In 2015, multiple myeloma (MM) represented 1% of all cancers and about 5% of hematologic malignancies in Saudi cancer registry. We conducted this large study because only small pilot studies have examined MM outcomes after autologous stem-cell transplantation (ASCT). The standard therapy for eligible patients is induction chemotherapy followed by ASCT. OBJECTIVES Determine the demographic characteristics of MM patients and the outcomes of ASCT. DESIGN Retrospective. SETTING Tumor registry database of major tertiary cancer care center in Riyadh. PATIENTS AND METHODS We identified patients with newly diagnosed MM who underwent ASCT from October 1997 to March 2015. MAIN OUTCOME MEASURES The demographic characteristics of MM patients and the outcomes of ASCT in the form of response evaluation, progression-free survival (PFS) and overall survival (OS). SAMPLE SIZE 169 patients with newly diagnosed MM. RESULTS The median age at diagnosis was 51 years (range 23-69) and 100 (59.2%) were male. The most common immunoglobulin (Ig) subtype was IgG-kappa (80 patients; 47.6%). Most patients presented with advanced ISS stage III (75 patients; 47.5%). The cytogenetic analysis was documented in only 87 patients (51.4%); about half (48.3%) had normal cytogenetics by fluorescence in situ hybridization. Deletion 13 was present in 18.4% of patients. In post-induction therapy, 84 patients (50%) achieved a complete response, which increased to 78.1% (132 patients) after ASCT. The median PFS and OS post-transplantation were 30 and 202 months, respectively. Only one patient (<1%) died in the first 100 days after transplantation. CONCLUSIONS Our transplant eligible MM patients tend to be younger with a higher OS and a low ASCT-related mortality (<1%) than is reported internationally. LIMITATIONS Usual limitations of a retrospective analysis using registry-level data; no data on quality of life. CONFLICTS OF INTEREST None.
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Affiliation(s)
- Ahmed Kotb Abdrabou
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,From the Department of Medicine, Hematology Unit, Zagazig University, Zagazig, Egypt
| | - Fahad Al Sharif
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Riad El Fakih
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shahrukh Hashmi
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Yasser Mohamed Khafaga
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saud Alhayli
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hazaa Al Zahrani
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Syed Ahmed
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Feras Al Fraih
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Marwan Shaheen
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Walid Rasheed
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Naeem Arshad Chaudhri
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fahad Al Mohareb
- From the King Faisal Cancer Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hala Khalil
- From the Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mahmoud Aljurf
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amr Hanbali
- From the Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Shahi A, Weiss GE, Bhattacharya S, Baiu DC, Marino R, Pula T, Callander NS, Asimakopoulos F, Otto M. Targeted treatment of multiple myeloma with a radioiodinated small molecule radiopharmaceutical. Leuk Lymphoma 2021; 62:1518-1521. [PMID: 33502270 DOI: 10.1080/10428194.2021.1876858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ankita Shahi
- Department of Pediatrics, School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Gerald E Weiss
- Department of Pediatrics, School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Saswati Bhattacharya
- Department of Medicine, Division of Hematology/Oncology, School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Dana C Baiu
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Roberta Marino
- Department of Therapeutics Production and Quality, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Taner Pula
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Natalie S Callander
- Department of Medicine, Division of Hematology/Oncology, School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Fotis Asimakopoulos
- Department of Medicine, Division of Hematology/Oncology, School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA.,Department of Medicine, Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California-San Diego, CA, USA
| | - Mario Otto
- Department of Pediatrics, School of Medicine and Public Health, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
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Huang TC, Huang SY, Yao M, Lin CY, Hwang WL, Gau JP, Tan TD, Wang PN, Liu YC, Lin SC, Kao RH, Pei SN, Yu MS, Lin HY, Su YC, Chen CC, Li SS, Wu YY. Autologous stem cell transplantation in multiple myeloma: Post-transplant outcomes of Taiwan Blood and Marrow Transplantation Registry. J Formos Med Assoc 2018; 118:471-480. [PMID: 30119948 DOI: 10.1016/j.jfma.2018.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 06/01/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND/PURPOSE Multiple myeloma (MM) is a monoclonal plasma cell malignancy. The primary choice of treatment for MM is induction therapy followed by autologous stem cell transplantation (ASCT). This study aimed to analyze the treatment efficacy of ASCT in a Taiwanese cohort and evaluate possible prognostic factors. METHODS From the database of the Taiwan Blood and Marrow Transplantation registry, data on 396 patients with MM who underwent ASCT were reviewed. RESULTS The average age of participants was 54.8 years, and there were more men than women (57.6% vs. 42.4%). Most patients were diagnosed with IgG-type myeloma (52.4%), followed by IgA-type (23.2%) and light-chain type (21.4%). Patients with Durie Salmon Staging System (DSS) III disease accounted for 61.9% of the study cohort, while 23.7% had stage II and 14.4% had stage I disease. The median progression-free survival (PFS) and overall survival (OS) after ASCT were 46.5 months and 70.4 months, respectively. DSS III was a poor prognostic factor affecting both PFS and OS with a duration of 35.9 months and 69.0 months, respectively, compared with the other two stages (p = 0.006 and p = 0.03, respectively). In addition, patients with better treatment response before ASCT had better PFS and OS compared with those who did not show a response (both p < 0.0001). The overall incidence of organ toxicities associated with transplantation was low. CONCLUSION In conclusion, our cohort showed that myeloma patients with early DSS and better treatment response before ASCT had better long-term survival outcomes.
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Affiliation(s)
- Tzu-Chuan Huang
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shang-Yi Huang
- Hematology-Oncology Section, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming Yao
- Hematology-Oncology Section, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Yuan Lin
- Division of Hematology and Oncology, Department of Medicine, China Medical University Hospital, Taiwan
| | - Wen-Li Hwang
- Division of Hematology/Medical Oncology, Taichung Veterans General Hospital, Taiwan
| | - Jyh-Pyng Gau
- Division of Hematology, Taipei Veterans General Hospital, National Yang-Ming University, Taiwan
| | - Tran-Der Tan
- Department of Hematology and Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taiwan
| | - Po-Nan Wang
- Division of Hematology, Chang Gung Medical Foundation, Linkou Branch, Taiwan
| | - Yi-Chang Liu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Chiang Lin
- Division of Oncology-Hematology, Far Eastern Memorial Hospital, Taiwan
| | - Ruey-Ho Kao
- Department of Hematology and Oncology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Sung-Nan Pei
- Kaohsiung Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Sun Yu
- Hematology/Oncology Division, Dept. of Medicine Veterans General Hospital, Kaohsiung, Taiwan
| | - Hsuan-Yu Lin
- Changhua Christian Hospital, Internal Medicine Department, Hematology and Oncology Division, Taiwan
| | - Yung-Cheng Su
- Division of Hemato-Oncology, Taipei Medical University-Shuang Ho Hospital, Taiwan
| | - Chih-Cheng Chen
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Sin-Syue Li
- Division of Hematology/Oncology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Ying Wu
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Vandross A. Proteasome inhibitor-based therapy for treatment of newly diagnosed multiple myeloma. Semin Oncol 2018; 44:381-384. [PMID: 29935899 DOI: 10.1053/j.seminoncol.2018.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/01/2018] [Indexed: 01/09/2023]
Abstract
Multiple myeloma is a hematologic malignancy that is unable to be cured and has significant impact throughout the world. Front line treatment has shifted but ultimately has landed on a bortezomib-based combination therapy. Carfilzomib is a next-generation proteasome inhibitor shown to improve both progression-free and overall survival in relapsed and refractory multiple myeloma in combination with lenalidomide and dexamethasone (KRd). Given the favorable response rates seen in phase II trials treating newly diagnosed myeloma, this combination is listed as a viable option for upfront treatment. This systematic review compares pharmacologic properties, clinical efficacy, and toxicities of carfilzomib- and bortezomib-based regimens.
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Affiliation(s)
- Andrae Vandross
- Division of Hematology/Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA.
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Lenalidomide: A Review in Newly Diagnosed Multiple Myeloma as Maintenance Therapy After ASCT. Drugs 2017; 77:1473-1480. [DOI: 10.1007/s40265-017-0795-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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