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Modified dose of melphalan-prednisone in multiple myeloma patients receiving bortezomib plus melphalan-prednisone treatment

Bortezomib plus melphalan-prednisone (VMP) is a standard treatment for multiple myeloma, particularly for patients who are ineligible for high-dose therapy. However, early discontinuation or treatment modification is often needed owing to adverse events. The aim of this study was to investigate the... Full description

Journal Title: The Korean journal of internal medicine November 2019, Vol.34(6), pp.1333-1346
Main Author: Lee, Se Ryeon
Other Authors: Choi, Hojoon , Lee, Byung Hyun , Kang, Ka-Won , Yu, Eun Sang , Kim, Dae Sik , Park, Yong , Choi, Chul Won , Kim, Byung Soo , Sung, Hwa Jung
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 2005-6648 ; PMID: 30360024 Version:1 ; DOI: 10.3904/kjim.2018.144
Link: http://pubmed.gov/30360024
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title: Modified dose of melphalan-prednisone in multiple myeloma patients receiving bortezomib plus melphalan-prednisone treatment
format: Article
creator:
  • Lee, Se Ryeon
  • Choi, Hojoon
  • Lee, Byung Hyun
  • Kang, Ka-Won
  • Yu, Eun Sang
  • Kim, Dae Sik
  • Park, Yong
  • Choi, Chul Won
  • Kim, Byung Soo
  • Sung, Hwa Jung
subjects:
  • Bortezomib
  • Melphalan
  • Modified
  • Multiple Myeloma
  • Prednisone
ispartof: The Korean journal of internal medicine, November 2019, Vol.34(6), pp.1333-1346
description: Bortezomib plus melphalan-prednisone (VMP) is a standard treatment for multiple myeloma, particularly for patients who are ineligible for high-dose therapy. However, early discontinuation or treatment modification is often needed owing to adverse events. The aim of this study was to investigate the clinical outcomes of modifying the dose of melphalan-prednisone (MP) in patients receiving VMP. We examined 67 patients who received a modified dose of MP, and 38 patients who received the regularly planned dose of MP. We then analyzed clinical differences between the groups. Although there was no difference in the proportion of discontinuation due to adverse events between dose groups, more patients in the planned-dose group experienced earlier discontinuation in general. The overall response rate (ORR) was 81.0% and complete response (CR) rate was 30.5%. After a median 15.7 months of follow-up, the median progression-free survival (PFS) and overall survival (OS) were 25.0 and 47.8 months, respectively. There was no significant difference in the ORR, CR, PFS, and OS of the two dose groups. A median of four cycles were delivered, and the median cumulative bortezomib dose was 41.6 mg/m2 . The median PFS in patients with doses ≥ 41.6 mg/m2 was longer than that in patients with doses < 41.6 mg/m2 (35.1 months vs. 9.6 months). However, when MP was < 50% of the planned dose, PFS and OS were poor. Modifying the dose of MP might be a feasible and effective therapeutic approach for multiple myeloma patients receiving VMP treatment.
language: eng
source:
identifier: E-ISSN: 2005-6648 ; PMID: 30360024 Version:1 ; DOI: 10.3904/kjim.2018.144
fulltext: fulltext
issn:
  • 20056648
  • 2005-6648
url: Link


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titleModified dose of melphalan-prednisone in multiple myeloma patients receiving bortezomib plus melphalan-prednisone treatment
creatorLee, Se Ryeon ; Choi, Hojoon ; Lee, Byung Hyun ; Kang, Ka-Won ; Yu, Eun Sang ; Kim, Dae Sik ; Park, Yong ; Choi, Chul Won ; Kim, Byung Soo ; Sung, Hwa Jung
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subjectBortezomib ; Melphalan ; Modified ; Multiple Myeloma ; Prednisone
descriptionBortezomib plus melphalan-prednisone (VMP) is a standard treatment for multiple myeloma, particularly for patients who are ineligible for high-dose therapy. However, early discontinuation or treatment modification is often needed owing to adverse events. The aim of this study was to investigate the clinical outcomes of modifying the dose of melphalan-prednisone (MP) in patients receiving VMP. We examined 67 patients who received a modified dose of MP, and 38 patients who received the regularly planned dose of MP. We then analyzed clinical differences between the groups. Although there was no difference in the proportion of discontinuation due to adverse events between dose groups, more patients in the planned-dose group experienced earlier discontinuation in general. The overall response rate (ORR) was 81.0% and complete response (CR) rate was 30.5%. After a median 15.7 months of follow-up, the median progression-free survival (PFS) and overall survival (OS) were 25.0 and 47.8 months, respectively. There was no significant difference in the ORR, CR, PFS, and OS of the two dose groups. A median of four cycles were delivered, and the median cumulative bortezomib dose was 41.6 mg/m2 . The median PFS in patients with doses ≥ 41.6 mg/m2 was longer than that in patients with doses < 41.6 mg/m2 (35.1 months vs. 9.6 months). However, when MP was < 50% of the planned dose, PFS and OS were poor. Modifying the dose of MP might be a feasible and effective therapeutic approach for multiple myeloma patients receiving VMP treatment.
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0Bortezomib plus melphalan-prednisone (VMP) is a standard treatment for multiple myeloma, particularly for patients who are ineligible for high-dose therapy. However, early discontinuation or treatment modification is often needed owing to adverse events. The aim of this study was to investigate the clinical outcomes of modifying the dose of melphalan-prednisone (MP) in patients receiving VMP.
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2Although there was no difference in the proportion of discontinuation due to adverse events between dose groups, more patients in the planned-dose group experienced earlier discontinuation in general. The overall response rate (ORR) was 81.0% and complete response (CR) rate was 30.5%. After a median 15.7 months of follow-up, the median progression-free survival (PFS) and overall survival (OS) were 25.0 and 47.8 months, respectively. There was no significant difference in the ORR, CR, PFS, and OS of the two dose groups. A median of four cycles were delivered, and the median cumulative bortezomib dose was 41.6 mg/m2 . The median PFS in patients with doses ≥ 41.6 mg/m2 was longer than that in patients with doses < 41.6 mg/m2 (35.1 months vs. 9.6 months). However, when MP was < 50% of the planned dose, PFS and OS were poor.
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abstractBortezomib plus melphalan-prednisone (VMP) is a standard treatment for multiple myeloma, particularly for patients who are ineligible for high-dose therapy. However, early discontinuation or treatment modification is often needed owing to adverse events. The aim of this study was to investigate the clinical outcomes of modifying the dose of melphalan-prednisone (MP) in patients receiving VMP.
doi10.3904/kjim.2018.144
pmid30360024
date2019-11