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Drugs & Aging
Published in: Drugs & Aging 6/2015

01-06-2015 | Review Article

Management of Elderly Patients with Plasma Cell Myeloma

Authors: Erica L. Campagnaro, Teresa E. Goebel, Hillard M. Lazarus

Published in: Drugs & Aging | Issue 6/2015

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Abstract

Plasma cell myeloma (PCM) is a hematologic malignancy that primarily affects the elderly. Approximately two-thirds of patients are aged 65 years or older at diagnosis. Major advances in testing, treatment, and supportive care have resulted in substantial improvement in overall survival in younger, standard-risk, PCM patients over the past 3 decades. However, this positive impact progressively diminishes with advancing age, with some studies showing no improvement in survival outcomes in the elderly. Slow improvement in survival for elderly PCM patients is likely multifactorial, influenced by factors such as age-related physiologic changes, increased comorbidities, decreased treatment tolerance, socioeconomic barriers, and possible differences in disease biology. The standard approach of basing treatment decisions on age and performance status does not account for this complexity, and can be insufficient to determine the risks and benefits of treatment. Comprehensive geriatric assessment (CGA) produces a more thorough iteration of the factors influencing an individual’s treatment risk, and can potentially identify targets for intervention to lower risk. Ongoing studies are looking at developing and refining the tools available for risk screening and assessment. Treating elderly PCM patients with novel agent-based regimens with or without autologous stem cell transplantation has improved response rates and survival in some studies, but elderly PCM patients have benefitted less than their younger counterparts from recent advances in PCM treatment. Personalizing treatment decisions, based on predictions of risk, determined by geriatric assessment, and response, determined by precision medicine (our understanding of the genetic, molecular, and cellular pathways that drive an individual’s cancer) will help maximize the benefit and minimize the risk of PCM treatment for each patient. Continued evaluation of new strategies and treatments for PCM in clinical trials specifically designed for elderly patients is needed to continue to improve outcomes for elderly PCM patients in the future.
Literature
1.
2.
3.
Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://​globocan.​iarc.​fr. Accessed Dec 2013.
4.
Kyle RA, Therneau TM, Rajkumar SV, et al. Incidence of multiple myeloma in Olmsted County, Minnesota: trend over 6 decades. Cancer. 2004;101:2667–74.PubMedCrossRef
5.
Turesson I, Velez R, Kristinsson SY, et al. Patterns of multiple myeloma during the past 5 decades: stable incidence rates for all age groups in the population but rapidly changing age distribution in the clinic. Mayo Clin Proc. 2010;85:225–30.PubMedCentralPubMedCrossRef
6.
Brenner H, Gondos A, Pulte D. Recent major improvement in long-term survival of younger patients with multiple myeloma. Blood. 2008;111:2521–6.PubMedCrossRef
7.
8.
Turesson I, Velez R, Kristinsson SY, et al. Patterns of improved survival in patients with multiple myeloma in the twenty-first century: a population-based study. J Clin Oncol. 2010;28:830–4.PubMedCentralPubMedCrossRef
9.
Kristinsson SY, Landgren O, Dickman PW, et al. Patterns of survival in multiple myeloma: a population-based study of patients diagnosed in Sweden from 1973 to 2003. J Clin Oncol. 2007;25:1993–9.PubMedCrossRef
10.
Campagnaro E, Jacobus S, Uno H, Oken M, Kyle R, Rajkumar SV, Greipp P, Vesole D, Weiss M, Fonseca R, Lazarus H. Survival outcomes in elderly patients with plasma cell myeloma: the three decade Eastern Cooperative Oncology Group Experience. J Clin Oncol ASCO Annual Meeting Abstracts#8021, 2011.
11.
Dimopoulos MA, Kastritis E, Delimpasi S, et al. Multiple myeloma in octogenarians: clinical features and outcome in the novel agent era. Eur J Haematol. 2012;89:10–5.PubMedCrossRef
12.
Fonseca R, Barlogie B, Bataille R, et al. Genetics and cytogenetics of multiple myeloma: a workshop report. Cancer Res. 2004;64:1546–58.PubMedCrossRef
13.
Fonseca R, Bergsagel PL, Drach J, et al. International Myeloma Working Group molecular classification of multiple myeloma: spotlight review. Leukemia. 2009;23:2210–21.PubMedCentralPubMedCrossRef
14.
Mikhael JR, Dingli D, Roy V, et al. Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines 2013. Mayo Clin Proc. 2013;88:360–76.PubMedCrossRef
15.
Stewart AK, Bergsagel PL, Greipp PR, et al. A practical guide to defining high-risk myeloma for clinical trials, patient counseling and choice of therapy. Leukemia. 2007;21:529–34.PubMedCrossRef
16.
17.
Avet-Loiseau H, Hulin C, Campion L, et al. Chromosomal abnormalities are major prognostic factors in elderly patients with multiple myeloma: the intergroupe francophone du myelome experience. J Clin Oncol. 2013;31:2806–9.PubMedCentralPubMedCrossRef
18.
19.
Baker SD, Grochow LB. Pharmacology of cancer chemotherapy in the older person. Clin Geriatr Med. 1997;13:169–83.PubMed
20.
Yuen GJ. Altered pharmacokinetics in the elderly. Clin Geriatr Med. 1990;6:257–67.PubMed
21.
Bringhen S, Mateos MV, Zweegman S, et al. Age and organ damage correlate with poor survival in myeloma patients: meta-analysis of 1435 individual patient data from 4 randomized trials. Haematologica. 2013;98:980–7.PubMedCentralPubMedCrossRef
22.
Ludwig H, Durie BG, Bolejack V, et al. Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival: an analysis of 10 549 patients from the International Myeloma Working Group. Blood. 2008;111:4039–47.PubMedCentralPubMedCrossRef
23.
Engelhardt M, Terpos E, Kleber M, et al. European Myeloma Network recommendations on the evaluation and treatment of newly diagnosed patients with multiple myeloma. Haematologica. 2014;99:232–42.PubMedCentralPubMedCrossRef
24.
Facon T, Mary JY, Pegourie B, et al. Dexamethasone-based regimens versus melphalan-prednisone for elderly multiple myeloma patients ineligible for high-dose therapy. Blood. 2006;107:1292–8.PubMedCrossRef
25.
Ludwig H, Hajek R, Tothova E, et al. Thalidomide-dexamethasone compared with melphalan-prednisolone in elderly patients with multiple myeloma. Blood. 2009;113:3435–42.PubMedCrossRef
26.
Palumbo A, Bertola A, Musto P, et al. Oral melphalan, prednisone, and thalidomide for newly diagnosed patients with myeloma. Cancer. 2005;104:1428–33.PubMedCrossRef
27.
Waage A, Gimsing P, Fayers P, et al. Melphalan and prednisone plus thalidomide or placebo in elderly patients with multiple myeloma. Blood. 2010;116:1405–12.PubMedCrossRef
28.
Rajkumar SV, Jacobus S, Callander NS, et al. Lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone as initial therapy for newly diagnosed multiple myeloma: an open-label randomised controlled trial. Lancet Oncol. 2010;11:29–37.PubMedCentralPubMedCrossRef
29.
Wildes TM, Rosko A, Tuchman SA. Multiple myeloma in the older adult: better prospects, more challenges. J Clin Oncol. 2014;32:2531–40.
30.
Hurria A, Togawa K, Mohile SG, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011;29:3457–65.PubMedCentralPubMedCrossRef
31.
Extermann M, Boler I, Reich RR, et al. Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer. 2012;118:3377–86.PubMedCrossRef
32.
Pal SK, Katheria V, Hurria A. Evaluating the older patient with cancer: understanding frailty and the geriatric assessment. CA Cancer J Clin. 2010;60:120–32.PubMedCrossRef
33.
Extermann M. Comprehensive geriatric assessment basics for the cancer professional. J Oncol Manag. 2003;12:13–7.PubMed
34.
Palumbo A, Bringhen S, Mateos MV, et al. Geriatric assessment predicts survival and toxicities in elderly myeloma: an International Myeloma Working Group report. Blood. 2015;125:2068–74.
35.
Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef
36.
Jaglowski SM, Ruppert AS, Hofmeister CC, et al. The hematopoietic stem cell transplant comorbidity index can predict for 30-day readmission following autologous stem cell transplant for lymphoma and multiple myeloma. Bone Marrow Transplant. 2014;49:1323–29.
37.
Sorror ML, Giralt S, Sandmaier BM, et al. Hematopoietic cell transplantation specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences. Blood. 2007;110:4606–13.PubMedCentralPubMedCrossRef
38.
Wildes TM, Stirewalt DL, Medeiros B, et al. Hematopoietic stem cell transplantation for hematologic malignancies in older adults: geriatric principles in the transplant clinic. J Natl Compr Canc Netw. 2014;12:128–36.PubMedCentralPubMed
39.
Hurria A, Wildes T, Blair SL, et al. Senior adult oncology, version 2.2014: clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2014;12:82–126.PubMed
40.
Repetto L, Fratino L, Audisio RA, et al. Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study. J Clin Oncol. 2002;20:494–502.PubMedCrossRef
41.
Freyer G, Geay JF, Touzet S, et al. Comprehensive geriatric assessment predicts tolerance to chemotherapy and survival in elderly patients with advanced ovarian carcinoma: a GINECO study. Ann Oncol. 2005;16:1795–800.PubMedCrossRef
42.
Rao AV, Hsieh F, Feussner JR, et al. Geriatric evaluation and management units in the care of the frail elderly cancer patient. J Gerontol A Biol Sci Med Sci. 2005;60:798–803.PubMedCrossRef
43.
Tucci M, Mosca A, Lamanna G, et al. Prognostic significance of disordered calcium metabolism in hormone-refractory prostate cancer patients with metastatic bone disease. Prostate Cancer Prostatic Dis. 2009;12:94–9.PubMedCrossRef
44.
Tucci M, Quatraro C, Dammacco F, et al. Role of active drug transporters in refractory multiple myeloma. Curr Top Med Chem. 2009;9:218–24.PubMedCrossRef
45.
Kim J, Hurria A. Determining chemotherapy tolerance in older patients with cancer. J Natl Compr Canc Netw. 2013;11:1494–502.PubMedCentralPubMed
46.
Extermann M, Aapro M, Bernabei R, et al. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005;55:241–52.PubMedCrossRef
47.
Bellera CA, Rainfray M, Mathoulin-Pelissier S, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol. 2012;23:2166–72.PubMedCrossRef
48.
Hurria A, Cirrincione CT, Muss HB, et al. Implementing a geriatric assessment in cooperative group clinical cancer trials: CALGB 360401. J Clin Oncol. 2011;29:1290–6.PubMedCentralPubMedCrossRef
49.
Hurria A, Gupta S, Zauderer M, et al. Developing a cancer-specific geriatric assessment: a feasibility study. Cancer. 2005;104:1998–2005.PubMedCrossRef
50.
Kleber M, Ihorst G, Terhorst M, et al. Comorbidity as a prognostic variable in multiple myeloma: comparative evaluation of common comorbidity scores and use of a novel MM-comorbidity score. Blood Cancer J. 2011;1:e35.PubMedCentralPubMedCrossRef
51.
Kleber M, Ihorst G, Udi J, et al. Prognostic risk factor evaluation in patients with relapsed or refractory multiple myeloma receiving lenalidomide treatment: analysis of renal function by eGFR and of additional comorbidities by comorbidity appraisal. Clin Lymphoma Myeloma Leuk. 2012;12:38–48.PubMedCrossRef
52.
Kleber M, Ihorst G, Gross B, et al. Validation of the Freiburg Comorbidity Index in 466 multiple myeloma patients and combination with the international staging system are highly predictive for outcome. Clin Lymphoma Myeloma Leuk. 2013;13:541–51.PubMedCrossRef
53.
Labonte L, Iqbal T, Zaidi MA, et al. Utility of comorbidity assessment in predicting transplantation-related toxicity following autologous hematopoietic stem cell transplantation for multiple myeloma. Biol Blood Marrow Transplant. 2008;14:1039–44.PubMedCrossRef
54.
Saad A, Mahindra A, Zhang MJ, et al. Hematopoietic cell transplant comorbidity index is predictive of survival after autologous hematopoietic cell transplantation in multiple myeloma. Biol Blood Marrow Transplant. 2014;20:402–408 e1.
55.
Farina L, Bruno B, Patriarca F, et al. The hematopoietic cell transplantation comorbidity index (HCT-CI) predicts clinical outcomes in lymphoma and myeloma patients after reduced-intensity or non-myeloablative allogeneic stem cell transplantation. Leukemia. 2009;23:1131–8.PubMedCrossRef
56.
American Cancer Society. Cancer facts and figures 2013. Atlanta: American Cancer Society; 2013.
57.
Palumbo A, Bringhen S, Ludwig H, et al. Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN). Blood. 2011;118:4519–29.PubMedCrossRef
58.
Palumbo A, Rajkumar SV, San Miguel JF, et al. International Myeloma Working Group consensus statement for the management, treatment, and supportive care of patients with myeloma not eligible for standard autologous stem-cell transplantation. J Clin Oncol. 2014;32:587–600.PubMedCentralPubMedCrossRef
59.
Klepin HD, Rizzieri D, Palumbo A, et al. Individualizing treatment decisions for older adults with hematologic malignancies. Am Soc Clin Oncol Educ Book. 2013:208–19.
60.
61.
62.
Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78:21–33.PubMedCrossRef
63.
Kariyawasan CC, Hughes DA, Jayatillake MM, et al. Multiple myeloma: causes and consequences of delay in diagnosis. QJM. 2007;100:635–40.PubMedCrossRef
64.
Snowden JA, Ahmedzai SH, Ashcroft J, et al. Guidelines for supportive care in multiple myeloma 2011. Br J Haematol. 2011;154:76–103.PubMedCrossRef
65.
Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. JAMA. 2009;302:741–9.PubMedCentralPubMedCrossRef
66.
Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733–42.PubMedCrossRef
67.
Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383:1721–30.PubMedCrossRef
68.
NCCN clinical practice guidelines in oncology: senior adult oncology. Version 1.2014. Fort Washington: National Comprehensive Cancer Network; 2013.
69.
70.
Pulte D, Gondos A, Brenner H. Improvement in survival of older adults with multiple myeloma: results of an updated period analysis of SEER data. Oncologist. 2011;16:1600–03.
71.
Bergsagel DE, Ross SW, Baker DT. Evaluation of new chemotherapeutic agents in the treatment of multiple myeloma. V. 1-Aminocyclopentanecarboxylic acid (NSC-1026). Cancer Chemother Rep. 1962;21:101–6.PubMed
72.
Kumar SK, Lee JH, Lahuerta JJ, et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study. Leukemia. 2012;26:149–57.PubMedCentralPubMedCrossRef
73.
Facon T, Mary JY, Hulin C, et al. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. Lancet. 2007;370:1209–18.PubMedCrossRef
74.
Gulbrandsen N, Waage A, Gimsing P, et al. A randomised placebo-controlled study with melphalan/prednisone vs melphalan/prednisone/thalidomide: quality of life and toxicity [abstract]. Hematologica. 2008;93:0209.
75.
Hulin C, Facon T, Rodon P, et al. Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial. J Clin Oncol. 2009;27:3664–70.PubMedCrossRef
76.
Palumbo A, Bringhen S, Caravita T, et al. Oral melphalan and prednisone chemotherapy plus thalidomide compared with melphalan and prednisone alone in elderly patients with multiple myeloma: randomised controlled trial. Lancet. 2006;367:825–31.PubMedCrossRef
77.
Beksac M, Haznedar R, Firatli-Tuglular T, et al. Addition of thalidomide to oral melphalan/prednisone in patients with multiple myeloma not eligible for transplantation: results of a randomized trial from the Turkish Myeloma Study Group. Eur J Haematol. 2011;86:16–22.PubMedCrossRef
78.
Wijermans P, Schaafsma M, Termorshuizen F, et al. Phase III study of the value of thalidomide added to melphalan plus prednisone in elderly patients with newly diagnosed multiple myeloma: the HOVON 49 Study. J Clin Oncol. 2010;28:3160–6.PubMedCrossRef
79.
Fayers PM, Palumbo A, Hulin C, et al. Thalidomide for previously untreated elderly patients with multiple myeloma: meta-analysis of 1685 individual patient data from 6 randomized clinical trials. Blood. 2011;118:1239–47.PubMedCrossRef
80.
Kapoor P, Rajkumar SV, Dispenzieri A, et al. Melphalan and prednisone versus melphalan, prednisone and thalidomide for elderly and/or transplant ineligible patients with multiple myeloma: a meta-analysis. Leukemia. 2011;25:689–96.PubMedCrossRef
81.
Dimopoulos MA, Delforge M, Hajek R, et al. Lenalidomide, melphalan, and prednisone, followed by lenalidomide maintenance, improves health-related quality of life in newly diagnosed multiple myeloma patients aged 65 years or older: results of a randomized phase III trial. Haematologica. 2013;98:784–8.PubMedCentralPubMedCrossRef
82.
Falco P, Cavallo F, Larocca A, et al. Lenalidomide–prednisone induction followed by lenalidomide–melphalan–prednisone consolidation and lenalidomide–prednisone maintenance in newly diagnosed elderly unfit myeloma patients. Leukemia. 2013;27:695–701.PubMedCrossRef
83.
Palumbo A, Hajek R, Delforge M, et al. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. N Engl J Med. 2012;366:1759–69.PubMedCrossRef
84.
Stewart KA, Jacobus S, Fonseca R, et al. E1A06, an Intergroup Phase III Randomized Controlled Trial comparing melphalan, prednisone, and thalidomide (MPT-T) versus melphalan, prednisone, and lenalidomide (MPR-R) in newly diagnosed multiple myeloma patients who are not candidates for high-dose therapy. ASCO Annual Meeting Abstracts, 2014.
85.
Dimopoulos MA, Richardson PG, Schlag R, et al. VMP (bortezomib, melphalan, and PREDNISONE) is active and well tolerated in newly diagnosed patients with multiple myeloma with moderately impaired renal function, and results in reversal of renal impairment: cohort analysis of the phase III VISTA study. J Clin Oncol. 2009;27:6086–93.PubMedCrossRef
86.
San Miguel JF, Schlag R, Khuageva NK, et al. Persistent overall survival benefit and no increased risk of second malignancies with bortezomib–melphalan–prednisone versus melphalan–prednisone in patients with previously untreated multiple myeloma. J Clin Oncol. 2013;31:448–55.PubMedCrossRef
87.
San Miguel JF, Schlag R, Khuageva NK, et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med. 2008;359:906–17.PubMedCrossRef
88.
Delforge M, Dhawan R, Robinson D Jr, et al. Health-related quality of life in elderly, newly diagnosed multiple myeloma patients treated with VMP vs. MP: results from the VISTA trial. Eur J Haematol. 2012;89:16–27.PubMedCrossRef
89.
Mateos MV, Oriol A, Martinez-Lopez J, et al. Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: a randomised trial. Lancet Oncol. 2010;11:934–41.PubMedCrossRef
90.
Moreau P, Pylypenko H, Grosicki S, et al. Subcutaneous versus intravenous administration of bortezomib in patients with relapsed multiple myeloma: a randomised, phase 3, non-inferiority study. Lancet Oncol. 2011;12:431–40.PubMedCrossRef
91.
Mateos MV, Oriol A, Martinez-Lopez J, et al. GEM2005 trial update comparing VMP/VTP as induction in elderly multiple myeloma patients: do we still need alkylators? Blood. 2014;124:1887–93.PubMedCrossRef
92.
Palumbo A, Bringhen S, Rossi D, et al. Bortezomib–melphalan–prednisone-thalidomide followed by maintenance with bortezomib–thalidomide compared with bortezomib–melphalan–prednisone for initial treatment of multiple myeloma: a randomized controlled trial. J Clin Oncol. 2010;28:5101–9.PubMedCrossRef
93.
Palumbo A, Bringhen S, Larocca A, et al. Bortezomib–melphalan–prednisone–thalidomide followed by maintenance with bortezomib–thalidomide compared with bortezomib–melphalan–prednisone for initial treatment of multiple myeloma: updated follow-up and improved survival. J Clin Oncol. 2014;32:634–40.PubMedCrossRef
94.
Kumar S, Flinn I, Richardson PG, et al. Randomized, multicenter, phase 2 study (EVOLUTION) of combinations of bortezomib, dexamethasone, cyclophosphamide, and lenalidomide in previously untreated multiple myeloma. Blood. 2012;119:4375–82.PubMedCrossRef
95.
Niesvizky R, Flinn IW, Rifkin R, Gabrail N, Charu V, Clowney B, Essell J, Gaffar Y, Warr TA, Neuwirth R, Corzo D, Reeves J. Efficacy and safety of three bortezomib-based combinations in elderly, newly diagnosed multiple myeloma patients: results from all randomized patients in the community-based, phase 3b UPFRONT study. 53rd Annual ASH Meeting, San Diego, 2011.
96.
Larocca A, Cavallo F, and Magarotto V, et al. Reduced dose-intensity subcutaneous bortezomib plus prednisone (VP) or plus cyclophosfamide (VCP) or plus melphalan (VMP) for newly diagnosed multiple myeloma patients older than 75 years of age. American Society of Hematology Annual Meeting Abstracts, 2013.
97.
Zonder JA, Crowley J, Hussein MA, et al. Lenalidomide and high-dose dexamethasone compared with dexamethasone as initial therapy for multiple myeloma: a randomized Southwest Oncology Group trial (S0232). Blood. 2010;116:5838–41.PubMedCentralPubMedCrossRef
98.
Facon T, Dimopoulos M, Dispenzieri A, et al. Initial phase 3 results of the first (Frontline Investigation of Lenalidomide + Dexamethasone versus Standard Thalidomide) trial (MM-010/IFM 0701) in newly diagnosed multiple myeloma (NDMM) patients (Pts) ineligible for stem cell transplantation (SCT). Blood. 2013;122.
99.
Benboubker L, Dimopoulos MA, Dispenzieri A, et al. Lenalidomide and dexamethasone in transplant-ineligible patients with myeloma. N Engl J Med. 2014;371:906–17.PubMedCrossRef
100.
Palumbo A, Magarotto V, and Bringhen S, et al. A randomized phase 3 trial of melphalan–lenalidomide–prednisone (MPR) or cyclophosphamide–prednisone–lenalidomide (CPR) vs lenalidomide plus dexamethasone (Rd) in elderly newly diagnosed multiple myeloma patients. American Society of Hematology Annual Meeting Abstracts 2013.
101.
Reeder CB, Reece DE, Kukreti V, et al. Cyclophosphamide, bortezomib and dexamethasone induction for newly diagnosed multiple myeloma: high response rates in a phase II clinical trial. Leukemia. 2009;23:1337–41.PubMedCentralPubMedCrossRef
102.
Reeder CB, Reece DE, Kukreti V, et al. Once- versus twice-weekly bortezomib induction therapy with CyBorD in newly diagnosed multiple myeloma. Blood. 2010;115:3416–7.PubMedCrossRef
103.
Lenhoff S, Hjorth M, Turesson I, et al. Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation. Haematologica. 2006;91:1228–33.PubMed
104.
Reece DE, Bredeson C, Perez WS, et al. Autologous stem cell transplantation in multiple myeloma patients <60 vs ≥60 years of age. Bone Marrow Transplant. 2003;32:1135–43.PubMedCrossRef
105.
Lenhoff S, Hjorth M, Westin J, et al. Impact of age on survival after intensive therapy for multiple myeloma: a population-based study by the Nordic Myeloma Study Group. Br J Haematol. 2006;133:389–96.PubMedCrossRef
106.
Gay F, Magarotto V, Crippa C, et al. Bortezomib induction, reduced-intensity transplantation, and lenalidomide consolidation–maintenance for myeloma: updated results. Blood. 2013;122:1376–83.PubMedCrossRef
107.
Palumbo A, Bringhen S, Petrucci MT, et al. Intermediate-dose melphalan improves survival of myeloma patients aged 50 to 70: results of a randomized controlled trial. Blood. 2004;104:3052–7.PubMedCrossRef
108.
Ludwig H, Adam Z, Tothova E, et al. Thalidomide maintenance treatment increases progression-free but not overall survival in elderly patients with myeloma. Haematologica. 2010;95:1548–54.PubMedCentralPubMedCrossRef
109.
Caltagirone S, Ruggeri M, Aschero S, et al. Chromosome 1 abnormalities in elderly patients with newly diagnosed multiple myeloma treated with novel therapies. Haematologica. 2014;99:1611–7.PubMedCentralPubMedCrossRef
110.
Burnette BL, Dispenzieri A, Kumar S, et al. Treatment trade-offs in myeloma: a survey of consecutive patients about contemporary maintenance strategies. Cancer. 2013;119:4308–15.PubMedCrossRef
Metadata
Title
Management of Elderly Patients with Plasma Cell Myeloma
Authors
Erica L. Campagnaro
Teresa E. Goebel
Hillard M. Lazarus
Publication date
01-06-2015
Publisher
Springer International Publishing
Published in
Drugs & Aging / Issue 6/2015
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI
https://doi.org/10.1007/s40266-015-0265-x

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Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

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