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Retrospective Study of Carfilzomib-Pomalidomide-Dexamethasone in Relapsed/Refractory Multiple Myeloma Patients in a Tertiary Care Hospital in India
Indian Journal of Hematology and Blood Transfusion ( IF 0.7 ) Pub Date : 2021-07-03 , DOI: 10.1007/s12288-021-01461-6
Pallavi Mehta 1 , Neha Yadav 1 , Bhaarat Folbs 1 , Jyotsna Kapoor 1 , Vishvdeep Khushoo 1 , Narendra Agrawal 1 , Rayaz Ahmed 1 , Dinesh Bhurani 1
Affiliation  

Carfilzomib is a second-in class Proteosome Inhibitor and has been approved for Relapsed/Refractory Multiple Myeloma (RRMM). We retrospectively retrieved and analyzed data of KPd combination both biweekly and weekly regimens at our centre from 1 st August 2017 and 31 st May 2020. Sixty-nine patients were treated with KPd with median age of 58 years. Median prior lines of chemotherapy were 2(1-15). Twenty-eight (40.5%) patients underwent autoSCT. Median no. of cycles was 4(1-12) and 3(1-13) with median time to response of 4(2-12) and 2(2-6) months in biweekly and once weekly regimen cohorts respectively. At last follow-up, overall response rate (ORR) was 65.2%{CR-n = 10 (14.5%), VGPR-n = 19 (27.5%), PR-n = 16 (23.2%)} with n = 13(18.8%) patients had PD and relapse was observed in n = 24(34.8%). Thirty (43.4%) patients received maintenance therapy {n = 21(70%)} or autoSCT {n = 9(30%)}. Common toxicities were anemia {n = 11(15.9 %)}, thrombocytopenia (n = 15(21.7%) and neutropenia (n = 16 (23.2%)}, hypertension {n = 28(40.5%)}, peripheral neuropathy (grade1/2) {n = 15(21.7%)}, infections [n = 18(26%) {bacterial [n = 9(13%),viral n = 7(10.1%), fungal n = 8(11.6%)}]. At a median follow-up of 18 months, the estimated median PFS was 11.3 months (95%C.I. 8.3– 14.2) whereas the estimated median OS was 28 months (95%C.I. 20.4-35.5) for the entire cohort. Mortality rate of 2.5% and 10% in two cohorts respectively. Commonest cause of death was PD and sepsis. KPD is a well-tolerated regimen for RRMM, which can be a bridge to ASCT, however with significant side effects.



中文翻译:

印度一家三级医院对卡非佐米-泊马度胺-地塞米松治疗复发/难治性多发性骨髓瘤患者的回顾性研究

Carfilzomib 是一种二类蛋白体抑制剂,已被批准用于复发/难治性多发性骨髓瘤 (RRMM)。我们回顾性地检索和分析了自 2017 年 8 月 1 日至 2020 年 5 月 31 日在我们中心采用双周和每周方案的 KPd 组合数据。69 名患者接受了 KPd 治疗,中位年龄为 58 岁。先前化疗的中位线数为 2(1-15)。28 名 (40.5%) 患者接受了 autoSCT。中位数 周期为 4 (1-12) 和 3 (1-13),在每两周和每周一次的方案队列中,中位反应时间分别为 4 (2-12) 和 2 (2-6) 个月。末次随访时,总缓解率 (ORR) 为 65.2%{CR-n = 10 (14.5%), VGPR-n = 19 (27.5%), PR-n = 16 (23.2%)},n = 13 (18.8%) 患者患有 PD,并且在 n = 24 (34.8%) 中观察到复发。三十(43。4%) 患者接受维持治疗 {n = 21(70%)} 或 autoSCT {n = 9(30%)}。常见的毒性是贫血{n = 11(15.9%)}、血小板减少症 (n = 15(21.7%) 和中性粒细胞减少症 (n = 16 (23.2%)}、高血压 {n = 28(40.5%)}、周围神经病变 (1 级) /2) {n = 15(21.7%)},感染 [n = 18(26%) {细菌 [n = 9(13%),病毒 n = 7(10.1%),真菌 n = 8(11.6%) }]. 在 18 个月的中位随访中,估计的中位 PFS 为 11.3 个月(95%CI 8.3-14.2),而估计的中位 OS 为 28 个月(95%CI 20.4-35.5)整个队列。两个队列的死亡率分别为 2.5% 和 10%。最常见的死因是 PD 和败血症。KPD 是 RRMM 的一种耐受性良好的方案,可以作为 ASCT 的桥梁,但有显着的副作用。6%)}]。在 18 个月的中位随访中,估计整个队列的中位 PFS 为 11.3 个月(95%CI 8.3-14.2),而估计的中位 OS 为 28 个月(95%CI 20.4-35.5)。两个队列的死亡率分别为 2.5% 和 10%。最常见的死因是 PD 和败血症。KPD 是 RRMM 的一种耐受性良好的方案,可以成为 ASCT 的桥梁,但具有显着的副作用。6%)}]。在 18 个月的中位随访中,估计整个队列的中位 PFS 为 11.3 个月(95%CI 8.3-14.2),而估计的中位 OS 为 28 个月(95%CI 20.4-35.5)。两个队列的死亡率分别为 2.5% 和 10%。最常见的死因是 PD 和败血症。KPD 是 RRMM 的一种耐受性良好的方案,可以成为 ASCT 的桥梁,但具有显着的副作用。

更新日期:2021-07-04
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