Mai, Elias K., Miah, Kaya, Bertsch, Uta, Duerig, Jan, Scheid, Christof, Weisel, Katja C., Kunz, Christina, Munder, Markus, Lindemann, Hans-Walter, Merz, Maximilian, Hose, Dirk, Jauch, Anna, Seckinger, Anja, Luntz, Steffen, Sauer, Sandra, Fuhrmann, Stephan, Brossart, Peter, Elmaagacli, Ahmet, Goerner, Martin, Bernhard, Helga, Hoffmann, Martin, Raab, Marc S., Blau, Igor W., Haenel, Mathias, Benner, Axel, Salwender, Hans J. and Goldschmidt, Hartmut . Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age. Leukemia. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5551

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Abstract

Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: <= 60 years (S1,n = 353), 61-65 years (S2,n = 107) and 66-70 years (S3,n = 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%,p = 0.05/<0.001). With respect to progression-free survival (log-rankp = 0.73), overall survival (log-rankp = 0.54) as well as time-to-progression (Gray'sp = 0.83) and non-relapse mortality (Gray'sp = 0.25), no differences were found between the three age groups. Our results imply that an intensive upfront therapy with a bortezomib-containing IT, MEL200/ASCT, lenalidomide consolidation, and maintenance should be applied to transplant-eligible MM patients up to 70 years of age.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Mai, Elias K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miah, KayaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bertsch, UtaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duerig, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheid, ChristofUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weisel, Katja C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kunz, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Munder, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lindemann, Hans-WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Merz, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hose, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jauch, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seckinger, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luntz, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sauer, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuhrmann, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brossart, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Elmaagacli, AhmetUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goerner, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bernhard, HelgaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raab, Marc S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blau, Igor W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haenel, MathiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benner, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salwender, Hans J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goldschmidt, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-326115
DOI: 10.1038/s41375-020-0976-9
Journal or Publication Title: Leukemia
Publisher: NATURE PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 1476-5551
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
STEM-CELL TRANSPLANTATION; DIAGNOSED MULTIPLE-MYELOMA; INTERNATIONAL STAGING SYSTEM; AUTOLOGOUS TRANSPLANTATION; GERIATRIC ASSESSMENT; PLUS LENALIDOMIDE; ELDERLY-PATIENTS; 200 MG/M(2); OPEN-LABEL; FOLLOW-UPMultiple languages
Oncology; HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32611

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