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Cited 3 time in webofscience Cited 3 time in scopus
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Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone

Authors
Lee, Ho SupKim, KihyunLee, Je-JungYoon, Sung-SooBang, Soo-MeeKim, Jin SeokEom, Hyeon-SeokYoon, Dok HyunLee, YoojinShin, Ho-JinPark, YongJo, Jae-CheolLee, Won SikDo, Young RokMun, Yeung-ChulLee, Mark HongKim, Hyo JungKim, Sung-HyunKim, Min KyoungLim, Sung-NamPark, Seong KyuYi, Jun HoLee, Jae HoonMin, Chang-Ki
Issue Date
Jan-2021
Publisher
SPRINGER JAPAN KK
Keywords
Elderly multiple myeloma; Relapsed and refractory; Lenalidomide and dexamethasone; Frailty; Survival
Citation
INTERNATIONAL JOURNAL OF HEMATOLOGY, v.113, no.1, pp 81 - 91
Pages
11
Indexed
SCIE
SCOPUS
Journal Title
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume
113
Number
1
Start Page
81
End Page
91
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/33957
DOI
10.1007/s12185-020-02988-6
ISSN
0925-5710
1865-3774
Abstract
We compared efficacy and safety, according to frailty, of elderly patients with relapsed and refractory multiple myeloma (RRMM) treated with lenalidomide and dexamethasone (Rd), for whom bortezomib treatment had failed. Patients, 164 (52.9%) and 146 (47.1%), were classified as non-frail and frail using a simplified frailty scale. The overall response rates (ORR) and survival outcomes were lower in frail than in non-frail patients (ORR: 56.2% vs. 67.7%,P = 0.069; median progression free survival: 13.17 vs. 17.80 months,P = 0.033; median overall survival: 23.00 vs. 36.27 months,P = 0.002, respectively). The number of treatment emergent adverse events in grade 3 or worse was higher in frail than in non-frail patients (41.8% vs. 24.4%,P = 0.002, respectively). In frail patients, independent poor prognostic factors for survival were two or more Charlson comorbidity index (CCI) score, prior to exposure to both bortezomib and thalidomide, and achieved less than partial response In conclusion, frailty could predict clinical outcomes of Rd treatment in elderly patients with RRMM who had failed prior bortezomib. In frail patients, lower CCI in addition to less previous treatment exposure and deep response were associated with better survival.
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Park, Yong
Anam Hospital (Department of Medical Oncology and Hematology, Anam Hospital)
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