Outcomes of VDPACE with an immunomodulatory agent as a salvage therapy in relapsed/refractory multiple myeloma with extramedullary disease

eJHaem

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Al-Ola Abdallah¹  Ghulam Rehman Mohyuddin²  Nausheen Ahmed¹  Meera Mohan³  Wei Cui⁴  Leyla Shune¹  Zahra Mahmoudjafari¹  Joseph McGuirk¹  Siddhartha Ganguly¹  Shebli Atrash⁵ 

[1] Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center;University of Kansas Medical Center;Division of Hematology/Oncology, Medical College of Wisconsin;Division of Pathology & Laboratory Medicine, University of Kansas Medical Center;Levine Cancer Institute, Carolinas Healthcare System

关键词: extramedullary disease;    multiple myeloma;    plasmacytoma;    salvage therapy;   

DOI  :  10.1002/jha2.275

来源: Wiley

【 摘 要 】

Extramedullary disease (EMD) is an aggressive form of multiple myeloma (MM). Confirming the presence of plasma cells outside the bone marrow makes the diagnosis of EMD. There is no clear consensus on the management of EMD in MM, and this entity continues to remain an unmet need. Rapidly controlling EMD to prevent end-organ damage is a priority. Retrospectively, we reviewed our database for patients with EMD that received treatment with bortezomib, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, etoposide (VDPACE) plus an immune modulator (IMiD) regimen. We identified 21 patients with a median age of 61 years. Ten patients received a VDPACE based regimen as a bridge to autologus stem cell transplant (ASCT). After a median follow-up of 51.4 months, the median overall survival (OS) and progression-free survival were 14.9 months (95% CI: 7.8-NA) and 5.5 months (95% CI: 3.9-NA), respectively. The overall response rate was 76%, with a manageable safety profile. Interestingly, these results were similar regardless of the presence of high-risk cytogenetics. The safety profile was acceptable. In conclusion, a salvage VDPACE-based regimen plus an IMiD remains an effective and safe bridging therapy to future ASCT and immunotherapy in relapsed/refractory multiple myeloma patients with EMD.

【 授权许可】

Unknown