Abstract
Although survival of elderly myeloma patients has significantly improved there is still a subset of patients who, despite being fit and achieving optimal responses, will die within 2 years of diagnosis due to myeloma progression. The objective of this study was to define a scoring prognostic index to identify this group of patients. We have evaluated the outcome of 490 newly diagnosed elderly myeloma patients included in two Spanish trials (GEM2005-GEM2010). Sixty-eight patients (13.8%) died within 2 years of diagnosis (early deaths) due to myeloma progression. Our study shows that the use of simple scoring model based on 4 widely available markers (elevated LDH, ISS 3, high risk CA or >75 years) can contribute to identify up-front these patients. Moreover, unsustained response (<6 months duration) emerged as one important predictor of early myeloma-related mortality associated with a significant increase in the risk of death related to myeloma progression. The identification of these patients at high risk of early death is relevant for innovative trials aiming to maintain the depth of first response, since many of them will not receive subsequent lines of therapy.
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Change history
08 March 2019
Following the publication of this article, the author notes that the following information was missed from the acknowledgments section: This study wassupported by the Cooperative Research Thematic Networkgrants RD12/0036/0058 and RD12/0036/0046 of the Redde Cancer (Cancer Network of Excellence); Instituto deSalud Carlos III, Spain, Instituto de Salud Carlos III/SubdirecciónGeneral de Investigación Sanitaria part-financedby the European Regional Development Fund (FIS: PI12/01761; PI12/02311; PI13/01469; PI14/01867, G03/136;Sara Borrell: CD13/00340); Asociación Española Contra elCáncer (GCB120981SAN) and FEDER.The authors wish to apologise for any inconveniencecaused.
08 March 2019
Following the publication of this article, the author notes that the following information was missed from the acknowledgments section:
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Acknowledgements
We thank Jorge Nuñez for the statistical review of the present work.
Author contributions
P.R.O., M.-V.M., and J.S.-M. were involved in the conception and design of the study and writing of the manuscript. P.R.O. and N.M.-C. did the statistical analysis. M.-V.M and J.S.-M. were principal investigators of both trials and were involved in the original design of the study, writing of the protocol, analyzing and interpreting the data. All the authors were involved in patient recruitment and reviewed and approved the paper.
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P.R.-O.: has served on the speaker’s bureau and as a member of advisory boards for Janssen and Celgene. M.-V.M.: has declared consultancy for: Janssen, Celgene, Takeda, Amgen. E.-M.O.: has declared consultancy for or honoraria from: Mundipharma, Celgene, Amgen, Novartis, Takeda, AbbVie, BMS, Janssen. B.P.: has declared grants and personal fees from Celgene, Janssen, Takeda, Sanofi, BMS and personal fees from Amgen and grants from Engmab. J.S.-M.: received honoraria as part of Advisory boards from Celgene, Novartis, Millenium, Janssen, Amgen, MSD, Sanofi, and BMS. A.O.: has served as a member of advisory boards for Janssen and Celgene. J.B.: received honoraria for lectures and advisory boards from Celgene and Janssen and grant support from Janssen. L.R.: received honoraria grom Janssen and Celgene. The remaining authors declare that they have no conflict of interest.
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Rodríguez-Otero, P., Mateos, M.V., Martínez-López, J. et al. Early myeloma-related death in elderly patients: development of a clinical prognostic score and evaluation of response sustainability role. Leukemia 32, 2427–2434 (2018). https://doi.org/10.1038/s41375-018-0072-6
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DOI: https://doi.org/10.1038/s41375-018-0072-6
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