Jichu yixue yu linchuang (Sep 2023)

Evaluating the difference in clinical efficacy for t(11;14) multiple myeloma patients with CD20- or CD20+

  • ZHAO Weihong, HUANG Bintao, LIU Rui, XIANG Caixia

DOI
https://doi.org/10.16352/j.issn.1001-6325.2023.09.1423
Journal volume & issue
Vol. 43, no. 9
pp. 1423 – 1427

Abstract

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Objective To examine the differences in therapy response and confirm the effective regimen for multiple myeloma (MM) patients with t (11; 14)/CD20- or CD20+, for the selection of transplantation as early treatment. Methods To find the differences in therapy response and to confirm the effective regimen for multiple myeloma (MM) patients with t (11; 14)/CD20- or CD20+, for the selection of transplantation as the early treatment. There were three cytogenetics groups: t(11; 14)/CD20- or CD20+ and low-risk profile including normal or cytogenetics other than t (11; 14). Eligible patients received the bortezomib-based induction and lenalidomide-based consolidation/maintenance regimen. Results Patients with t(11;14) gained adverse therapy response for bortezomib induction regimen than other low-risk arm (OR rate: 11.1% versus 84.0% versus 85.2%, P＜0.01). A prospective found that although the patients with t(11;14)/CD20- showed the poor overall response for the bortezomib-based regimen, lenalidomide-based treatment schedule makes them gain a similar therapy advantage comparing with t(11;14)/ CD20+ and other low-risk group in the study The subgroup analyses of progression-free survival(PFS) and overall survival(OS) by continued lenalidomide-based consolidation/maintenance treatment also showed a benefit for lenalidomide therapy compared with observation regardless of cytogenetic risk profile and response at baseline (PFS at 4 years reached 75.0% versus 77.1% versus 84.2%, OS at 4 years was 75.0% versus 88.5% versus 90.4%, respectively). Moreover, the lenalidomide regimen little induced the incidence of fatal complications and was tolerated. There were only 3.2%, 8.4% and 15.8% patients had agranulocytosis, peripheral neuropathy and infection of 3-4 grade. Conclusions Lenalidomide regimen is more effective for t (11, 14)/ CD20- risk MM and t(11;14)/CD20+ and other cytogenetically low-risk MM are consistent in PFS and OS. In addition, the initial response rate of MM patients with unsatisfactory bortezomib treatment can also be improved.

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