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Serum C-reactive protein at diagnosis and response to therapy is the most powerful factor predicting outcome of multiple myeloma treated with thalidomide/ anthracycline-based therapy
Authors:Offidani Massimo  Corvatta Laura  Polloni Claudia  Piersantelli Maria-Novella  Galieni Piero  Visani Giuseppe  Alesiani Francesco  Catarini Massimo  Brunori Marino  Burattini Maurizio  Centurioni Riccardo  Ferranti Mario  Giuliodori Luciano  Candela Marco  Mele Anna  Marconi Monica  Leoni Pietro
Institution:Clinica di Ematologia Azienda Ospedaliero-Universitaria, Ospedali Riuniti Ancona, Italy. m.offidani@ospedaliriuniti.marche.it
Abstract:BackgroundFew studies have focused on factors affecting outcome in patients with multiple myeloma (MM) treated with thalidomide-based therapy. We investigated factors affecting response, progression-free survival (PFS), and overall survival (OS) in patients with MM treated with the thalidomide, dexamethasone, and pegylated liposomal doxorubicin (ThaDD) regimen with the aim to select patients benefiting more from this therapy.Patients and MethodsSixty-six patients with MM were treated first line with the ThaDD regimen. We analyzed demographics and disease-related characteristics to search for factors affecting response (≥ very good partial remission VGPR] vs. < VGPR], PFS, and OS.ResultsOverall, 45 patients (68%) showed response ≥ VGPR; median TTP and OS were 23.5 months and 35.5 months, respectively. Multivariate analysis selected only serum C-reactive protein (sCRP) as a predictive factor for response (P < .0001). By multivariate analysis, normal sCRP level (P = .001) and response to treatment ≥ VGPR (P = .007) were found to be associated with longer PFS. The factors that remained significantly associated with a longer OS when assessed by multivariate analysis were normal sCRP level (P = .005) and response to therapy ≥ VGPR (P = .019).ConclusionSerum C-reactive protein before therapy and response after therapy are the only factors useful in identifying patients benefiting from anthracycline/thalidomide—based therapy.
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