Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone

The Korean Multiple Myeloma Working Party (KMMWP)

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

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.

Original languageEnglish
Pages (from-to)81-91
Number of pages11
JournalInternational Journal of Hematology
Volume113
Issue number1
DOIs
StatePublished - Jan 2021

Bibliographical note

Funding Information:
The authors would like to thank the Korean Multiple Myeloma Working Party and all the researchers and research nurses for their help in data collection and Sangjin Lee who analyzed data statistically. We would like to thank Editage (www.editage.co.kr ) for English language editing.

Publisher Copyright:
© 2020, Japanese Society of Hematology.

Keywords

  • Elderly multiple myeloma
  • Frailty
  • Lenalidomide and dexamethasone
  • Relapsed and refractory
  • Survival

Fingerprint

Dive into the research topics of 'Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone'. Together they form a unique fingerprint.

Cite this