Treatment of relapsed/refractory multiple myeloma with thalidomide-based regimens: identification of prognostic factors.
We evaluated the predictive value of several parameters, including the International Staging System (ISS) for myeloma, in patients with advanced disease treated with thalidomide-based regimens (TBR). We analyzed 119 patients, from 3 phase II studies. Patients with pretreatment beta2 microglobulin<3.5 mg/l and albumin 3.5 g/dl were scored ISS stage 1, patients with beta2 microglobulin<3.5 mg/l and albumin<3.5 g/dl or beta2 microglobulin 3.5-5.5 mg/l regardless of albumin levels were scored ISS stage 2, patients with beta2 microglobulin>5.5 mg/l ISS stage 3. ISS stage was 1, 2 and 3 in 45, 32 and 23% of patients respectively. Seventy-four patients (62%) achieved at least partial response. Median progression-free and overall survival were 8 months and 19.5 months respectively. ISS stage, serum LDH and performance status were independent predictive factors for survival. Based on these 3 variables a scoring system was developed with survival times of 38.1, 28.8 and 5.8 months for scores 0, 1 and 2 respectively. The ISS staging system was highly predictive for overall survival of patients with advanced myeloma treated with TBR. With the addition of performance status and serum LDH, a simple scoring system was developed which may help select patients likely to benefit from TBR.
Anagnostopoulos
Athanasios
A
Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece.
Gika
Dimitra
D
Hamilos
George
G
Zervas
Konstantinos
K
Zomas
Athanasios
A
Pouli
Anastasia
A
Zorzou
Markela
M
Kastritis
Efstathios
E
Anagnostopoulos
Nikolaos
N
Tassidou
Anna
A
Anagnostou
Dimitra
D
Dimopoulos
Meletios-Athanasios
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000096:biosynthesis; D020533:Angiogenesis Inhibitors / Q000494:pharmacology; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012008:Recurrence; D012044:Regression Analysis; D012074:Remission Induction; D013792:Thalidomide / Q000494:pharmacology*; D013997:Time Factors; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000097:blood
D000418:Albumins; D020533:Angiogenesis Inhibitors; D001613:beta 2-Microglobulin; D013792:Thalidomide; D007770:L-Lactate Dehydrogenase