Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Chemotherapy adherence is a favorable prognostic factor for elderly patients with multiple myeloma who are treated with a frontline bortezomib-containing regimen

  • Cho, Hee-Jeong (Department of Hematology/Oncology, Kyungpook National University Hospital) ;
  • Seo, Sang-Kyung (Department of Hematology/Oncology, Kyungpook National University Hospital) ;
  • Baek, Dong Won (Department of Hematology/Oncology, Kyungpook National University Hospital) ;
  • Park, Sung-Woo (Department of Hematology/Oncology, Kyungpook National University Hospital) ;
  • Lee, Yoo-Jin (Department of Hematology/Oncology, Kyungpook National University Hospital) ;
  • Sohn, Sang-Kyun (Department of Hematology/Oncology, Kyungpook National University Hospital) ;
  • Lee, Ho-Sup (Department of Hematology/Oncology, Kosin University Gospel Hospital) ;
  • Lee, Won Sik (Department of Hematology-Oncology, Inje University Pusan Baik Hospital) ;
  • Lee, Ji Hyun (Department of Hematology-Oncology, Dong-A University Hospital) ;
  • Kim, Sung Hyun (Department of Hematology-Oncology, Dong-A University Hospital) ;
  • Moon, Joon-Ho (Department of Hematology/Oncology, Kyungpook National University Hospital)
  • Received : 2018.04.30
  • Accepted : 2018.06.08
  • Published : 2018.06.30
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Abstract

Background: Elderly patients with multiple myeloma (MM) are vulnerable to adverse events (AEs). This study evaluated adherence to chemotherapy and treatment outcomes in elderly patients treated with a frontline bortezomib (BTZ), melphalan, and prednisone (VMP) regimen and regimens without BTZ. Methods: One-hundred and forty elderly patients who were diagnosed with MM from March 2007 to March 2015 were included in this retrospective study. To evaluate regimen adherence, patients who were treated with more than 4 cycles were assigned to the good adherence group. Results: Among the 140 patients, 71 were treated with a frontline VMP and 69 with non-BTZ regimens. The median age was 71 years (range, 65-90 years). The VMP group showed a higher complete response rate than the non-BTZ group: 26.8% vs. 7.2%. More patients in the VMP group achieved ${\geq}$very good partial response (VGPR) and ${\geq}PR$. In the VMP group, 27 patients (38.0%) received less than 4 cycles. The VMP good adherence group showed a higher 3-year overall survival (OS) rate (70.9%) than the poor adherence group (60.2%, p=0.059). In the multivariate analysis, treatment with ${\geq}4$ cycles of VMP was a favorable factor for OS. Conclusion: A good adherence to a frontline VMP regimen resulted in favorable long-term survival. Adequate management of AEs will be needed to achieve favorable outcomes in elderly patients with MM.

Keywords

References

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