The treatment outcome of multiple myeloma patients ineligible for hematopoietic transplantation—a single institutional experience in Taiwan

Tzu Chuan Huang, Jia Hong Chen, Yi Ying Wu, Ping Ying Chang, Ming Shen Dai, Tsu Yi Chao, Woei Yau Kao, Yeu Chin Chen, Ching Liang Ho

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Multiple myeloma (MM) is characterized by the neoplastic proliferation of monoclonal plasma cells in the bone marrow and results in complications. In Taiwan, melphalan and several novel agents are used to treat myeloma patients who are not candidate for hematopoietic stem cell transplant (HSCT). This retrospective study aimed to evaluate the characteristics, treatment outcome, and prognostic factors of MM patients who were ineligible for HSCT at our institution from October 2000 until November 2012. A total of 101 MM patients were reviewed. The median age was 71.0 years, and median overall survival (OS) was 22.0 months. Most of patients were diagnosed as IgG-type myeloma (55.4 %). The initial presentations included anemia (89.1 %), skeletal events (49.5 %), severe renal insufficiency (30.7 %), and hypercalcemia (28.7 %). With regard to the frontline therapy, thalidomide/steroid was the most common. Infection was the leading cause of death and adverse effects. Treatment with bortezomib, almost in the second- or third-line setting, was associated with longer median OS (35.5 months) and the median time to progression (TTP) (6.0 months). Bortezomib treatment, chemotherapy, International Staging System (ISS) stage I, and better performance status significantly correlated with survival benefit. In the bortezomib-treated subgroup, better treatment response caused excellent median OS (67.7 months) and also significantly delayed TTP. Therefore, this current analysis concluded a median OS of 22 months in myeloma patients ineligible for HSCT at our institution during the past 10 years. The use of bortezomib with better treatment response also achieved significantly better median OS and TTP.

Original languageEnglish
Pages (from-to)107-115
Number of pages9
JournalAnnals of Hematology
Volume94
Issue number1
DOIs
Publication statusPublished - 2015

Fingerprint

Multiple Myeloma
Taiwan
Survival
Hematopoietic Stem Cells
Transplants
Therapeutics
Melphalan
Thalidomide
Hypercalcemia
Plasma Cells
Renal Insufficiency
Anemia
Cause of Death
Retrospective Studies
Immunoglobulin G
Bone Marrow
Steroids
Drug Therapy
Bortezomib
Infection

Keywords

  • Bortezomib
  • Hematopoietic transplantation
  • Infection
  • Multiple myeloma
  • Overall survival

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

The treatment outcome of multiple myeloma patients ineligible for hematopoietic transplantation—a single institutional experience in Taiwan. / Huang, Tzu Chuan; Chen, Jia Hong; Wu, Yi Ying; Chang, Ping Ying; Dai, Ming Shen; Chao, Tsu Yi; Kao, Woei Yau; Chen, Yeu Chin; Ho, Ching Liang.

In: Annals of Hematology, Vol. 94, No. 1, 2015, p. 107-115.

Research output: Contribution to journalArticle

Huang, Tzu Chuan ; Chen, Jia Hong ; Wu, Yi Ying ; Chang, Ping Ying ; Dai, Ming Shen ; Chao, Tsu Yi ; Kao, Woei Yau ; Chen, Yeu Chin ; Ho, Ching Liang. / The treatment outcome of multiple myeloma patients ineligible for hematopoietic transplantation—a single institutional experience in Taiwan. In: Annals of Hematology. 2015 ; Vol. 94, No. 1. pp. 107-115.
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abstract = "Multiple myeloma (MM) is characterized by the neoplastic proliferation of monoclonal plasma cells in the bone marrow and results in complications. In Taiwan, melphalan and several novel agents are used to treat myeloma patients who are not candidate for hematopoietic stem cell transplant (HSCT). This retrospective study aimed to evaluate the characteristics, treatment outcome, and prognostic factors of MM patients who were ineligible for HSCT at our institution from October 2000 until November 2012. A total of 101 MM patients were reviewed. The median age was 71.0 years, and median overall survival (OS) was 22.0 months. Most of patients were diagnosed as IgG-type myeloma (55.4 {\%}). The initial presentations included anemia (89.1 {\%}), skeletal events (49.5 {\%}), severe renal insufficiency (30.7 {\%}), and hypercalcemia (28.7 {\%}). With regard to the frontline therapy, thalidomide/steroid was the most common. Infection was the leading cause of death and adverse effects. Treatment with bortezomib, almost in the second- or third-line setting, was associated with longer median OS (35.5 months) and the median time to progression (TTP) (6.0 months). Bortezomib treatment, chemotherapy, International Staging System (ISS) stage I, and better performance status significantly correlated with survival benefit. In the bortezomib-treated subgroup, better treatment response caused excellent median OS (67.7 months) and also significantly delayed TTP. Therefore, this current analysis concluded a median OS of 22 months in myeloma patients ineligible for HSCT at our institution during the past 10 years. The use of bortezomib with better treatment response also achieved significantly better median OS and TTP.",
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