Improved survival of patients with primary plasma cell leukemia with VRd or daratumumab‐based quadruplets: A multicenter study by the Greek myeloma study group
We evaluated the efficacy and prognostic impact of bortezomib‐lenalidomide triplet (VRd) or daratumumab‐based quadruplets (DBQ) versus previous anti‐myeloma therapies, that is, bortezomib standard combinations (BSC) or conventional chemotherapy (CT), in a large cohort of patients with primary plasma...
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| Veröffentlicht in: | American journal of hematology 2023-05, Vol.98 (5), p.730-738 |
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| creator | Katodritou, Eirini Kastritis, Efstathios Dalampira, Dimitra Delimpasi, Sosana Spanoudakis, Emmanouil Labropoulou, Vasiliki Ntanasis‐Stathopoulos, Ioannis Gkioka, Annita‐Ioanna Giannakoulas, Nikos Kanellias, Nikolaos Papadopoulou, Theodosia Sevastoudi, Aggeliki Michalis, Eyrydiki Papathanasiou, Maria Kotsopoulou, Maria Sioni, Anastasia Triantafyllou, Theodora Daiou, Aikaterini Papadatou, Mavra Kyrtsonis, Marie‐Christine Pouli, Anastasia Kostopoulos, Ioannis Verrou, Evgenia Dimopoulos, Meletios‐Athanasios Terpos, Evangelos |
| description | We evaluated the efficacy and prognostic impact of bortezomib‐lenalidomide triplet (VRd) or daratumumab‐based quadruplets (DBQ) versus previous anti‐myeloma therapies, that is, bortezomib standard combinations (BSC) or conventional chemotherapy (CT), in a large cohort of patients with primary plasma cell leukemia (pPCL), including those fulfilling the revised diagnostic criteria, that is, circulating plasma cells (cPCS): ≥5%; 110 pPCL patients (M/F: 51/59; median age 65 years, range: 44–86) out of 3324 myeloma patients (3%), registered in our database between 2001 and 2021, were studied; 37% had cPCS 5%–19%; 89% received novel combinations including DBQ (21%), VRd (16%) and BSC (52%); 35% underwent autologous stem cell transplantation. 83% achieved objective responses. Treatment with VRd/DBQ strongly correlated with a higher complete response rate (41% vs. 17%; p = .008). After a median follow‐up of 51 months (95% CI: 45–56), 67 patients died. Early mortality was 3.5%. Progression‐free survival was 16 months (95% CI: 12–19.8), significantly longer in patients treated with VRd/DBQ versus BSC/CT (25 months, 95% CI: 13.5–36.5 vs. 13 months 95% CI: 9–16.8; p = .03). Median overall survival (OS) was 29 months (95% CI: 19.6–38.3), significantly longer in patients treated with VRd/DBQ versus BSC/CT (not reached vs. 20 months, 95% CI: 14–26; 3‐year OS: 70% vs. 32%, respectively; p |
| doi_str_mv | 10.1002/ajh.26891 |
| format | Article |
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Treatment with VRd/DBQ strongly correlated with a higher complete response rate (41% vs. 17%; p = .008). After a median follow‐up of 51 months (95% CI: 45–56), 67 patients died. Early mortality was 3.5%. Progression‐free survival was 16 months (95% CI: 12–19.8), significantly longer in patients treated with VRd/DBQ versus BSC/CT (25 months, 95% CI: 13.5–36.5 vs. 13 months 95% CI: 9–16.8; p = .03). Median overall survival (OS) was 29 months (95% CI: 19.6–38.3), significantly longer in patients treated with VRd/DBQ versus BSC/CT (not reached vs. 20 months, 95% CI: 14–26; 3‐year OS: 70% vs. 32%, respectively; p < .001; HzR: 3.88). In the multivariate analysis VRd/DBQ therapy, del17p(+) and PLT <100.000/μL, independently predicted OS (p < .05). Our study has demonstrated that in the real‐world setting, treatment with VRd/DBQ induces deep and durable responses and is a strong prognostic factor for OS representing currently the best therapeutic option for pPCL.</description><identifier>ISSN: 0361-8609</identifier><identifier>EISSN: 1096-8652</identifier><identifier>DOI: 10.1002/ajh.26891</identifier><identifier>PMID: 36869876</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Bortezomib ; Bortezomib - therapeutic use ; Chemotherapy ; Dexamethasone ; Greece ; Hematology ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunotherapy ; Leukemia ; Leukemia, Plasma Cell - therapy ; Monoclonal antibodies ; Multiple myeloma ; Multiple Myeloma - drug therapy ; Multivariate analysis ; Myeloma ; Plasma cell leukemia ; Plasma cells ; Stem cell transplantation ; Targeted cancer therapy ; Transplantation, Autologous</subject><ispartof>American journal of hematology, 2023-05, Vol.98 (5), p.730-738</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-4e1b2aff4f9e73c92eadc0cbfd1b1fae38ad571bcf917be3cbc1401ff73b17173</citedby><cites>FETCH-LOGICAL-c3531-4e1b2aff4f9e73c92eadc0cbfd1b1fae38ad571bcf917be3cbc1401ff73b17173</cites><orcidid>0000-0003-1152-6959 ; 0000-0002-6328-9783 ; 0000-0001-8191-5832 ; 0000-0001-7523-7510 ; 0000-0001-5133-1422 ; 0000-0001-9404-807X ; 0000-0001-6987-4716 ; 0000-0001-8990-3254</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fajh.26891$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fajh.26891$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27903,27904,45553,45554,46388,46812</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36869876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Katodritou, Eirini</creatorcontrib><creatorcontrib>Kastritis, Efstathios</creatorcontrib><creatorcontrib>Dalampira, Dimitra</creatorcontrib><creatorcontrib>Delimpasi, Sosana</creatorcontrib><creatorcontrib>Spanoudakis, Emmanouil</creatorcontrib><creatorcontrib>Labropoulou, Vasiliki</creatorcontrib><creatorcontrib>Ntanasis‐Stathopoulos, Ioannis</creatorcontrib><creatorcontrib>Gkioka, Annita‐Ioanna</creatorcontrib><creatorcontrib>Giannakoulas, Nikos</creatorcontrib><creatorcontrib>Kanellias, Nikolaos</creatorcontrib><creatorcontrib>Papadopoulou, Theodosia</creatorcontrib><creatorcontrib>Sevastoudi, Aggeliki</creatorcontrib><creatorcontrib>Michalis, Eyrydiki</creatorcontrib><creatorcontrib>Papathanasiou, Maria</creatorcontrib><creatorcontrib>Kotsopoulou, Maria</creatorcontrib><creatorcontrib>Sioni, Anastasia</creatorcontrib><creatorcontrib>Triantafyllou, Theodora</creatorcontrib><creatorcontrib>Daiou, Aikaterini</creatorcontrib><creatorcontrib>Papadatou, Mavra</creatorcontrib><creatorcontrib>Kyrtsonis, Marie‐Christine</creatorcontrib><creatorcontrib>Pouli, Anastasia</creatorcontrib><creatorcontrib>Kostopoulos, Ioannis</creatorcontrib><creatorcontrib>Verrou, Evgenia</creatorcontrib><creatorcontrib>Dimopoulos, Meletios‐Athanasios</creatorcontrib><creatorcontrib>Terpos, Evangelos</creatorcontrib><title>Improved survival of patients with primary plasma cell leukemia with VRd or daratumumab‐based quadruplets: A multicenter study by the Greek myeloma study group</title><title>American journal of hematology</title><addtitle>Am J Hematol</addtitle><description>We evaluated the efficacy and prognostic impact of bortezomib‐lenalidomide triplet (VRd) or daratumumab‐based quadruplets (DBQ) versus previous anti‐myeloma therapies, that is, bortezomib standard combinations (BSC) or conventional chemotherapy (CT), in a large cohort of patients with primary plasma cell leukemia (pPCL), including those fulfilling the revised diagnostic criteria, that is, circulating plasma cells (cPCS): ≥5%; 110 pPCL patients (M/F: 51/59; median age 65 years, range: 44–86) out of 3324 myeloma patients (3%), registered in our database between 2001 and 2021, were studied; 37% had cPCS 5%–19%; 89% received novel combinations including DBQ (21%), VRd (16%) and BSC (52%); 35% underwent autologous stem cell transplantation. 83% achieved objective responses. Treatment with VRd/DBQ strongly correlated with a higher complete response rate (41% vs. 17%; p = .008). After a median follow‐up of 51 months (95% CI: 45–56), 67 patients died. Early mortality was 3.5%. Progression‐free survival was 16 months (95% CI: 12–19.8), significantly longer in patients treated with VRd/DBQ versus BSC/CT (25 months, 95% CI: 13.5–36.5 vs. 13 months 95% CI: 9–16.8; p = .03). Median overall survival (OS) was 29 months (95% CI: 19.6–38.3), significantly longer in patients treated with VRd/DBQ versus BSC/CT (not reached vs. 20 months, 95% CI: 14–26; 3‐year OS: 70% vs. 32%, respectively; p < .001; HzR: 3.88). In the multivariate analysis VRd/DBQ therapy, del17p(+) and PLT <100.000/μL, independently predicted OS (p < .05). Our study has demonstrated that in the real‐world setting, treatment with VRd/DBQ induces deep and durable responses and is a strong prognostic factor for OS representing currently the best therapeutic option for pPCL.</description><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Bortezomib</subject><subject>Bortezomib - therapeutic use</subject><subject>Chemotherapy</subject><subject>Dexamethasone</subject><subject>Greece</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Leukemia</subject><subject>Leukemia, Plasma Cell - therapy</subject><subject>Monoclonal antibodies</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - drug therapy</subject><subject>Multivariate analysis</subject><subject>Myeloma</subject><subject>Plasma cell leukemia</subject><subject>Plasma cells</subject><subject>Stem cell transplantation</subject><subject>Targeted cancer therapy</subject><subject>Transplantation, Autologous</subject><issn>0361-8609</issn><issn>1096-8652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtuFDEQhi0EIpPAggsgS2zIYhK73Q-b3SiCPBQpEgK2LT_KTE_s6Y7dnqh3HIErcDVOgpMeWERiVZbq01fl-hF6Q8kJJaQ4lZv1SVFzQZ-hBSWiXvK6Kp6jBWE1zW8iDtBhjBtCKC05eYkOWM1rwZt6gX5d-iH0OzA4prDrdtLh3uJBjh1sx4jvu3GNh9B5GSY8OBm9xBqcww7SLfhOzsS3zwb3ARsZ5Jh88lL9_vFTyZi1d0makAYHY_yAV9gnN3Y6uyHgOCYzYTXhcQ34PADcYj-B6_OMufU99Gl4hV5Y6SK83tcj9PXTxy9nF8vrm_PLs9X1UrOK0WUJVBXS2tIKaJgWBUijiVbWUEWtBMalqRqqtBW0UcC00rQk1NqGKdrQhh2h97M33-MuQRxb38WHv8ot9Cm2RcNZKYioWEbfPUE3fQrbvF2mBOdV1VQkU8czpUMfYwDb7g_ZUtI-5Nbm3NrH3DL7dm9MyoP5R_4NKgOnM3DfOZj-b2pXVxez8g8Uaqc5</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Katodritou, Eirini</creator><creator>Kastritis, Efstathios</creator><creator>Dalampira, Dimitra</creator><creator>Delimpasi, Sosana</creator><creator>Spanoudakis, Emmanouil</creator><creator>Labropoulou, Vasiliki</creator><creator>Ntanasis‐Stathopoulos, Ioannis</creator><creator>Gkioka, Annita‐Ioanna</creator><creator>Giannakoulas, Nikos</creator><creator>Kanellias, Nikolaos</creator><creator>Papadopoulou, Theodosia</creator><creator>Sevastoudi, Aggeliki</creator><creator>Michalis, Eyrydiki</creator><creator>Papathanasiou, Maria</creator><creator>Kotsopoulou, Maria</creator><creator>Sioni, Anastasia</creator><creator>Triantafyllou, Theodora</creator><creator>Daiou, Aikaterini</creator><creator>Papadatou, Mavra</creator><creator>Kyrtsonis, Marie‐Christine</creator><creator>Pouli, Anastasia</creator><creator>Kostopoulos, Ioannis</creator><creator>Verrou, Evgenia</creator><creator>Dimopoulos, Meletios‐Athanasios</creator><creator>Terpos, Evangelos</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1152-6959</orcidid><orcidid>https://orcid.org/0000-0002-6328-9783</orcidid><orcidid>https://orcid.org/0000-0001-8191-5832</orcidid><orcidid>https://orcid.org/0000-0001-7523-7510</orcidid><orcidid>https://orcid.org/0000-0001-5133-1422</orcidid><orcidid>https://orcid.org/0000-0001-9404-807X</orcidid><orcidid>https://orcid.org/0000-0001-6987-4716</orcidid><orcidid>https://orcid.org/0000-0001-8990-3254</orcidid></search><sort><creationdate>202305</creationdate><title>Improved survival of patients with primary plasma cell leukemia with VRd or daratumumab‐based quadruplets: A multicenter study by the Greek myeloma study group</title><author>Katodritou, Eirini ; Kastritis, Efstathios ; Dalampira, Dimitra ; Delimpasi, Sosana ; Spanoudakis, Emmanouil ; Labropoulou, Vasiliki ; Ntanasis‐Stathopoulos, Ioannis ; Gkioka, Annita‐Ioanna ; Giannakoulas, Nikos ; Kanellias, Nikolaos ; Papadopoulou, Theodosia ; Sevastoudi, Aggeliki ; Michalis, Eyrydiki ; Papathanasiou, Maria ; Kotsopoulou, Maria ; Sioni, Anastasia ; Triantafyllou, Theodora ; Daiou, Aikaterini ; Papadatou, Mavra ; Kyrtsonis, Marie‐Christine ; Pouli, Anastasia ; Kostopoulos, Ioannis ; Verrou, Evgenia ; Dimopoulos, Meletios‐Athanasios ; Terpos, Evangelos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-4e1b2aff4f9e73c92eadc0cbfd1b1fae38ad571bcf917be3cbc1401ff73b17173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - 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Academic</collection><jtitle>American journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Katodritou, Eirini</au><au>Kastritis, Efstathios</au><au>Dalampira, Dimitra</au><au>Delimpasi, Sosana</au><au>Spanoudakis, Emmanouil</au><au>Labropoulou, Vasiliki</au><au>Ntanasis‐Stathopoulos, Ioannis</au><au>Gkioka, Annita‐Ioanna</au><au>Giannakoulas, Nikos</au><au>Kanellias, Nikolaos</au><au>Papadopoulou, Theodosia</au><au>Sevastoudi, Aggeliki</au><au>Michalis, Eyrydiki</au><au>Papathanasiou, Maria</au><au>Kotsopoulou, Maria</au><au>Sioni, Anastasia</au><au>Triantafyllou, Theodora</au><au>Daiou, Aikaterini</au><au>Papadatou, Mavra</au><au>Kyrtsonis, Marie‐Christine</au><au>Pouli, Anastasia</au><au>Kostopoulos, Ioannis</au><au>Verrou, Evgenia</au><au>Dimopoulos, Meletios‐Athanasios</au><au>Terpos, Evangelos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved survival of patients with primary plasma cell leukemia with VRd or daratumumab‐based quadruplets: A multicenter study by the Greek myeloma study group</atitle><jtitle>American journal of hematology</jtitle><addtitle>Am J Hematol</addtitle><date>2023-05</date><risdate>2023</risdate><volume>98</volume><issue>5</issue><spage>730</spage><epage>738</epage><pages>730-738</pages><issn>0361-8609</issn><eissn>1096-8652</eissn><abstract>We evaluated the efficacy and prognostic impact of bortezomib‐lenalidomide triplet (VRd) or daratumumab‐based quadruplets (DBQ) versus previous anti‐myeloma therapies, that is, bortezomib standard combinations (BSC) or conventional chemotherapy (CT), in a large cohort of patients with primary plasma cell leukemia (pPCL), including those fulfilling the revised diagnostic criteria, that is, circulating plasma cells (cPCS): ≥5%; 110 pPCL patients (M/F: 51/59; median age 65 years, range: 44–86) out of 3324 myeloma patients (3%), registered in our database between 2001 and 2021, were studied; 37% had cPCS 5%–19%; 89% received novel combinations including DBQ (21%), VRd (16%) and BSC (52%); 35% underwent autologous stem cell transplantation. 83% achieved objective responses. Treatment with VRd/DBQ strongly correlated with a higher complete response rate (41% vs. 17%; p = .008). After a median follow‐up of 51 months (95% CI: 45–56), 67 patients died. Early mortality was 3.5%. Progression‐free survival was 16 months (95% CI: 12–19.8), significantly longer in patients treated with VRd/DBQ versus BSC/CT (25 months, 95% CI: 13.5–36.5 vs. 13 months 95% CI: 9–16.8; p = .03). Median overall survival (OS) was 29 months (95% CI: 19.6–38.3), significantly longer in patients treated with VRd/DBQ versus BSC/CT (not reached vs. 20 months, 95% CI: 14–26; 3‐year OS: 70% vs. 32%, respectively; p < .001; HzR: 3.88). In the multivariate analysis VRd/DBQ therapy, del17p(+) and PLT <100.000/μL, independently predicted OS (p < .05). Our study has demonstrated that in the real‐world setting, treatment with VRd/DBQ induces deep and durable responses and is a strong prognostic factor for OS representing currently the best therapeutic option for pPCL.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36869876</pmid><doi>10.1002/ajh.26891</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1152-6959</orcidid><orcidid>https://orcid.org/0000-0002-6328-9783</orcidid><orcidid>https://orcid.org/0000-0001-8191-5832</orcidid><orcidid>https://orcid.org/0000-0001-7523-7510</orcidid><orcidid>https://orcid.org/0000-0001-5133-1422</orcidid><orcidid>https://orcid.org/0000-0001-9404-807X</orcidid><orcidid>https://orcid.org/0000-0001-6987-4716</orcidid><orcidid>https://orcid.org/0000-0001-8990-3254</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0361-8609 |
| ispartof | American journal of hematology, 2023-05, Vol.98 (5), p.730-738 |
| issn | 0361-8609 1096-8652 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2783490953 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Bortezomib Bortezomib - therapeutic use Chemotherapy Dexamethasone Greece Hematology Hematopoietic Stem Cell Transplantation Humans Immunotherapy Leukemia Leukemia, Plasma Cell - therapy Monoclonal antibodies Multiple myeloma Multiple Myeloma - drug therapy Multivariate analysis Myeloma Plasma cell leukemia Plasma cells Stem cell transplantation Targeted cancer therapy Transplantation, Autologous |
| title | Improved survival of patients with primary plasma cell leukemia with VRd or daratumumab‐based quadruplets: A multicenter study by the Greek myeloma study group |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T07%3A52%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Improved%20survival%20of%20patients%20with%20primary%20plasma%20cell%20leukemia%20with%20VRd%20or%20daratumumab%E2%80%90based%20quadruplets:%20A%20multicenter%20study%20by%20the%20Greek%20myeloma%20study%20group&rft.jtitle=American%20journal%20of%20hematology&rft.au=Katodritou,%20Eirini&rft.date=2023-05&rft.volume=98&rft.issue=5&rft.spage=730&rft.epage=738&rft.pages=730-738&rft.issn=0361-8609&rft.eissn=1096-8652&rft_id=info:doi/10.1002/ajh.26891&rft_dat=%3Cproquest_cross%3E2798855750%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2798855750&rft_id=info:pmid/36869876&rfr_iscdi=true |