<scp>LDH</scp> is an adverse prognostic factor independent of <scp>ISS</scp> in transplant‐eligible myeloma patients receiving bortezomib‐based induction regimens

Chim, Chor Sang; Sim, Joycelyn; Tam, Sidney; Tse, Eric; Kwong, Yok Lam

doi:10.1111/ejh.12434

Cited by 26 publications

(18 citation statements)

References 15 publications

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“…Previous studies confirmed that LDH is an adverse prognostic factor for myeloma. Chim et al 24 reported that LDH is an adverse prognostic factor independent of ISS in transplant-eligible myeloma patients receiving bortezomib-based induction regimens. Moreover, multivariate analysis including LDH, ISS stage, etc showed that ISS stage was no longer an independent prognostic factor.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of different bortezomib-based regimens in Chinese myeloma patients

Wang

et al. 2016

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Bortezomib has significantly increased the response rates in multiple myeloma (MM), but optimal bortezomib-based regimens for initial MM therapy have not yet been defined. We retrospectively compared the outcomes of 128 patients newly diagnosed with symptomatic MM who received either bortezomib combined with dexamethasone (PD) or three-drug combinations of PD with liposomal doxorubicin (PAD) or thalidomide (PTD). The overall response rate (ORR), very good partial response (VGPR) rate, and complete remission CR/near-complete remission (nCR) results were better for the PAD and PTD regimens than for the PD group. Three-year overall survival (OS) was 80.1%, 72.5%, and 61.8% with PAD, PTD, and PD regimens, respectively. The 3-year OS rate of PAD and PTD was significantly higher than that of PD (80.1% vs 61.8%, P=0.024; 72.5% vs 61.8%, P=0.035), but the difference was not statistically significant between PAD and PTD (80.1% vs 72.5%, P=0.843). Similarly, the PAD and PTD regimens resulted in significantly superior 3-year progression-free survival (PFS) rates. The patients in the PTD arm were more frequently observed with grade 1–3 peripheral neuropathy (PN), compared to those in the PAD and PD groups, especially grade 2–3 PN. PN developed less frequently without sacrificing the efficacy when bortezomib was administered subcutaneously rather than intravenously. Our experience suggests that the three-drug combinations PAD and PTD produce a better outcome than PD, especially with respect to PAD, with fewer adverse events.

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes of different bortezomib-based regimens in Chinese myeloma patients

Wang

et al. 2016

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“…Our data confirm that patients with LCMM have poorer outcome than other MM subtypes, in terms of OS. This worse prognosis is justified, to a certain point, by the association of LCMM with several established negative prognostic factors such as ISS III [6], renal failure [7], male sex [8], high LDH levels [9] and high FLCr i/u [10]. After adjustment for key prognostic factors, LCMM remains an independent factor associated with OS.…”

Section: Discussionmentioning

confidence: 99%

Light Chain Multiple Myeloma: A Single Institution Series

Ríos-Tamayo¹,

Sánchez²,

Veas³

et al. 2015

J Leuk

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performance status score, the presence of high-risk cytogenetic abnormalities by FISH including IgH translocations such as t(4;14) or t(14;16), del17p or abnormalities of chromosome 1, and ISS. Renal function was assessed by serum creatinine (sCr, mg/dL) and the estimated glomerular filtration rate (eGFR) according to the MDRD (modification of diet in renal disease) formula. Other variables of increasing interest were also included, such as the body mass index (BMI), the occurrence of weight loss before diagnosis, the delay in diagnosis (time from the first MM-related event to the bone marrow examination) as well as the therapeutic delay (time from bone marrow examination to date of initial treatment), the serum free light chain involved/uninvolved ratio (FLCr i/u), lactate dehydrogenase (LDH), C reactive protein, and the percentage of bone marrow plasma cell (BMPC) as measured by morphology. Patients were treated with conventional chemotherapy until 2006, when we started to use a bortezomib-based induction approach. ASCT has been used since 1995. Median overall survival (OS) was calculated in months (m) from the date of diagnosis (first bone marrow aspirate or biopsy) until

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“…Based on analysis of multiple clinico‐pathological risk factors in 2031 patients with diffuse large B cell lymphoma treated by anthracycline‐containing regimens, elevated LDH is one of the five factors (age, stage, LDH, performance status, number of extranodal sites) prognostic of survival in the International Prognostic Index (Shipp et al , ). Similarly, elevated LDH was also found to be an important adverse prognostic factor in multiple myeloma by Barlogie et al (), and subsequently verified in other studies (Chim et al , ; Palumbo et al , ), Indeed, elevated LDH, in addition to high‐risk fluorescence in situ hybridisation (FISH) aberration, was incorporated into the Revised International Staging System (ISS), whereby the 5‐year overall survival for stages 1, 2 and 3 were 82%, 62% and 40% years (Palumbo et al , ).…”

Section: Prognostic Staging System In Al Amyloidosismentioning

confidence: 70%

Lactate dehydrogenase as a prognostic marker in AL amyloidosis: expected or unexpected?

Chim

2017

Br J Haematol

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LDH is an adverse prognostic factor independent of ISS in transplant‐eligible myeloma patients receiving bortezomib‐based induction regimens

Abstract: In this uniformly treated cohort of transplant-eligible myeloma patients, elevated serum LDH is an adverse risk factor independent of ISS for both OS and EFS. Bortezomib-based induction/ASCT regimen had not abolished the adverse impact of elevated LDH.

Cited by 26 publications

References 15 publications

Long-term outcomes of different bortezomib-based regimens in Chinese myeloma patients

Long-term outcomes of different bortezomib-based regimens in Chinese myeloma patients

Light Chain Multiple Myeloma: A Single Institution Series

Lactate dehydrogenase as a prognostic marker in AL amyloidosis: expected or unexpected?

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