Clinical characteristics and survival analysis of patients with triple/quad-class exposed relapsed or refractory multiple myeloma
10.12354/j.issn.1000-8179.2024.20241173
- VernacularTitle:三类/四类暴露复发难治性多发性骨髓瘤患者的临床特征及生存分析
- Author:
An JING
1
;
Zhao JIE
;
Ma YANPING
;
Qin XIAOQI
;
Ma YAOFANG
;
Li ZHIHUA
;
Lang JUNYUAN
;
Gao GUORONG
;
Liu WENHUA
;
Duan WENYI
;
Wei JUNNI
;
Tian WEIWEI
Author Information
1. 山西医科大学公共卫生学院(太原市 030001)
- Publication Type:Journal Article
- Keywords:
relapsed or refractory multiple myeloma(RRMM);
triple/quad-class exposure;
chimeric antigen receptor T-cell therapy(CAR-T);
survival analysis;
B-cell maturation antigen(BCMA);
targeted therapy
- From:
Chinese Journal of Clinical Oncology
2024;51(23):1218-1222
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and survival prognosis of patients with triple/quad-class exposed relapsed or refractory multiple myeloma(RRMM).Methods:The clinical data of patients with triple/quad-class exposed RRMM from eight centers in Shanxi Province between May 2017 and May 2024 were retrospectively analyzed.Overall survival(OS)and progression-free survival(PFS)were analyzed using the Kaplan-Meier method,and factors affecting survival were examined by the Cox proportional hazards model and Log-rank test.Results:Among the 112 patients with triple-class exposure,16 were quadruple-class exposed.The detection rates of high-risk cytogenetic abnormalities and extramedullary lesions in patients with triple-class exposure were 57.1%and 36.6%,respectively,while those in patients with quadruple-class exposure were 87.5%and 62.5%,respectively.The median PFS and OS of patients with triple-class expos-ure were 5.6 months and 12.2 months,respectively,while those of patients with quadruple-class exposure were 9.4 months and 16.9 months,respectively.Cox model analysis showed that extramedullary lesions and multi-line treatment(≥3 lines)were independent risk factors for the survival of patients with triple-class exposed RRMM(P<0.05).Previous autologous stem cell transplantation,subsequent con-ventional drug treatment,and B-cell maturation antigen(BCMA)chimeric antigen receptor T-cell(CAR-T)treatment were protective factors(P<0.05).After triple-class drug resistance,the Log-rank test verified that BCMA CAR-T treatment significantly prolonged the median PFS of patients compared to conventional drug treatment(9.4 months vs.5.2 months,P=0.026 9),whereas the difference in OS was not statistic-ally significant(16.9 months vs.7.9 months,P=0.263 4).Conclusions:Patients with triple/quad-class exposed RRMM have a poor prognosis,and BCMA CAR-T cell therapy can improve survival in patients with triple-class drug-resistant RRMM.
