المؤلفون: Encinas, Cristina, Hernandez-Rivas, José-Ángel, Oriol, Albert, Rosiñol, Laura, Blanchard, María-Jesús, Bellón, José-María, García-Sanz, Ramón, de la Rubia, Javier, de la Guía, Ana López, Jímenez-Ubieto, Ana, Jarque, Isidro, Iñigo, Belén, Dourdil, Victoria, de Arriba, Felipe, Pérez-Ávila, Clara Cuéllar, Gonzalez, Yolanda, Hernández, Miguel-Teodoro, Bargay, Joan, Granell, Miguel, Rodríguez-Otero, Paula

المصدر: Blood Cancer Journal; Apr2022, Vol. 12 Issue 4, p1-8, 8p

مصطلحات موضوعية: MULTIPLE myeloma, DISEASE risk factors, ANTIBIOTIC prophylaxis, SERUM albumin, PATIENTS' attitudes, MONOCLONAL gammopathies

مستخلص: Infections remain a common complication in patients with multiple myeloma (MM) and are associated with morbidity and mortality. A risk score to predict the probability of early severe infection could help to identify the patients that would benefit from preventive measures. We undertook a post hoc analysis of infections in four clinical trials from the Spanish Myeloma Group, involving a total of 1347 patients (847 transplant candidates). Regarding the GEM2010 > 65 trial, antibiotic prophylaxis was mandatory, so we excluded it from the final analysis. The incidence of severe infection episodes within the first 6 months was 13.8%, and majority of the patients experiencing the first episode before 4 months (11.1%). 1.2% of patients died because of infections within the first 6 months (1% before 4 months). Variables associated with increased risk of severe infection in the first 4 months included serum albumin ≤30 g/L, ECOG > 1, male sex, and non-IgA type MM. A simple risk score with these variables facilitated the identification of three risk groups with different probabilities of severe infection within the first 4 months: low-risk (score 0–2) 8.2%; intermediate-risk (score 3) 19.2%; and high-risk (score 4) 28.3%. Patients with intermediate/high risk could be candidates for prophylactic antibiotic therapies. [ABSTRACT FROM AUTHOR]

: Copyright of Blood Cancer Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Mosquera Orgueira, Adrian, González Pérez, Marta Sonia, Diaz Arias, Jose, Rosiñol, Laura, Oriol, Albert, Teruel, Ana Isabel, Martinez Lopez, Joaquin, Palomera, Luis, Granell, Miguel, Blanchard, Maria Jesus, de la Rubia, Javier, López de la Guia, Ana, Rios, Rafael, Sureda, Anna, Hernandez, Miguel Teodoro, Bengoechea, Enrique, Calasanz, María José, Gutierrez, Norma, Martin, Maria Luis, Blade, Joan

المصدر: Blood Cancer Journal; Apr2022, Vol. 12 Issue 4, p1-9, 9p

مصطلحات موضوعية: MULTIPLE myeloma, MACHINE learning, MONOCLONAL gammopathies, PROGNOSTIC models, DIAGNOSIS

مستخلص: The International Staging System (ISS) and the Revised International Staging System (R-ISS) are commonly used prognostic scores in multiple myeloma (MM). These methods have significant gaps, particularly among intermediate-risk groups. The aim of this study was to improve risk stratification in newly diagnosed MM patients using data from three different trials developed by the Spanish Myeloma Group. For this, we applied an unsupervised machine learning clusterization technique on a set of clinical, biochemical and cytogenetic variables, and we identified two novel clusters of patients with significantly different survival. The prognostic precision of this clusterization was superior to those of ISS and R-ISS scores, and appeared to be particularly useful to improve risk stratification among R-ISS 2 patients. Additionally, patients assigned to the low-risk cluster in the GEM05 over 65 years trial had a significant survival benefit when treated with VMP as compared with VTD. In conclusion, we describe a simple prognostic model for newly diagnosed MM whose predictions are independent of the ISS and R-ISS scores. Notably, the model is particularly useful in order to re-classify R-ISS score 2 patients in 2 different prognostic subgroups. The combination of ISS, R-ISS and unsupervised machine learning clusterization brings a promising approximation to improve MM risk stratification. [ABSTRACT FROM AUTHOR]

: Copyright of Blood Cancer Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Puig, Noemi, Hernández, Miguel T., Rosiñol, Laura, González, Esther, de Arriba, Felipe, Oriol, Albert, González-Calle, Verónica, Escalante, Fernando, de la Rubia, Javier, Gironella, Mercedes, Ríos, Rafael, García-Sánchez, Ricarda, Arguiñano, José M., Alegre, Adrián, Martín, Jesús, Gutiérrez, Norma. C., Calasanz, María J., Martín, María L., Couto, María del Carmen, Casanova, María

المصدر: Blood Cancer Journal; May2021, Vol. 11 Issue 5, p1-11, 11p

مصطلحات موضوعية: DEXAMETHASONE, CLARITHROMYCIN, AUTOGRAFTS, MULTIPLE myeloma treatment, RANDOMIZED controlled trials

مستخلص: Although case-control analyses have suggested an additive value with the association of clarithromycin to continuous lenalidomide and dexamethasone (Rd), there are not phase III trials confirming these results. In this phase III trial, 286 patients with MM ineligible for ASCT received Rd with or without clarithromycin until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). With a median follow-up of 19 months (range, 0–54), no significant differences in the median PFS were observed between the two arms (C-Rd 23 months, Rd 29 months; HR 0.783, p = 0.14), despite a higher rate of complete response (CR) or better in the C-Rd group (22.6% vs 14.4%, p = 0.048). The most common G3–4 adverse events were neutropenia [12% vs 19%] and infections [30% vs 25%], similar between the two arms; however, the percentage of toxic deaths was higher in the C-Rd group (36/50 [72%] vs 22/40 [55%], p = 0.09). The addition of clarithromycin to Rd in untreated transplant ineligible MM patients does not improve PFS despite increasing the ≥CR rate due to the higher number of toxic deaths in the C-Rd arm. Side effects related to overexposure to steroids due to its delayed clearance induced by clarithromycin in this elderly population could explain these results. The trial was registered in clinicaltrials.gov with the name GEM-CLARIDEX: Ld vs BiRd and with the following identifier NCT02575144. The full trial protocol can be accessed from ClinicalTrials.gov. This study received financial support from BMS/Celgene. [ABSTRACT FROM AUTHOR]

: Copyright of Blood Cancer Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)