TY  - JOUR
A1  - Bachmann, Friederike
A1  - Schreder, Martin
A1  - Engelhardt, Monika
A1  - Langer, Christian
A1  - Wolleschak, Denise
A1  - Mügge, Lars Olof
A1  - Dürk, Heinz
A1  - Schäfer-Eckart, Kerstin
A1  - Blau, Igor Wolfgang
A1  - Gramatzki, Martin
A1  - Liebisch, Peter
A1  - Grube, Matthias
A1  - Metzler, Ivana v.
A1  - Bassermann, Florian
A1  - Metzner, Bernd
A1  - Röllig, Christoph
A1  - Hertenstein, Bernd
A1  - Khandanpour, Cyrus
A1  - Dechow, Tobias
A1  - Hebart, Holger
A1  - Jung, Wolfram
A1  - Theurich, Sebastian
A1  - Maschmeyer, Georg
A1  - Salwender, Hans
A1  - Hess, Georg
A1  - Bittrich, Max
A1  - Rasche, Leo
A1  - Brioli, Annamaria
A1  - Eckardt, Kai-Uwe
A1  - Straka, Christian
A1  - Held, Swantje
A1  - Einsele, Hermann
A1  - Knop, Stefan
T1  - Kinetics of renal function during induction in newly diagnosed multiple myeloma: results of two prospective studies by the German Myeloma Study Group DSMM
JF  - Cancers
N2  - Background: Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) helps to prevent excess toxicity. Patients (pts) from two prospective trials were analyzed, provided postinduction (PInd) restaging was performed. Pts received three cycles with bortezomib (btz), cyclophosphamide, and dexamethasone (dex; VCD) or btz, lenalidomide (len), and dex (VRd) or len, adriamycin, and dex (RAD). The minimum required estimated glomerular filtration rate (eGFR) was >30 mL/min. We analyzed the percent change of the renal function using the International Myeloma Working Group (IMWG) criteria and Kidney Disease: Improving Global Outcomes (KDIGO)-defined categories. Results: Seven hundred and seventy-two patients were eligible. Three hundred and fifty-six received VCD, 214 VRd, and 202 RAD. VCD patients had the best baseline eGFR. The proportion of pts with eGFR <45 mL/min decreased from 7.3% at baseline to 1.9% PInd (p < 0.0001). Thirty-seven point one percent of VCD versus 49% of VRd patients had a decrease of GFR (p = 0.0872). IMWG-defined “renal complete response (CRrenal)” was achieved in 17/25 (68%) pts after VCD, 12/19 (63%) after RAD, and 14/27 (52%) after VRd (p = 0.4747). Conclusions: Analyzing a large and representative newly diagnosed myeloma (NDMM) group, we found no difference in CRrenal that occurred independently from the myeloma response across the three regimens. A trend towards deterioration of the renal function with VRd versus VCD may be explained by a better pretreatment “renal fitness” in the latter group.
KW  - multiple myeloma
KW  - renal failure
KW  - kidney
KW  - bortezomib
KW  - lenalidomide
KW  - induction regimen
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234139
SN  - 2072-6694
VL  - 13
IS  - 6
ER  - 
TY  - JOUR
A1  - Engelhardt, Monika
A1  - Terpos, Evangelos
A1  - Kleber, Martina
A1  - Gay, Francesca
A1  - Wäsch, Ralph
A1  - Morgan, Gareth
A1  - Cavo, Michele
A1  - van de Donk, Niels
A1  - Beilhack, Andreas
A1  - Bruno, Benedetto
A1  - Johnsen, Hans Erik
A1  - Hajek, Roman
A1  - Driessen, Christoph
A1  - Ludwig, Heinz
A1  - Beksac, Meral
A1  - Boccadoro, Mario
A1  - Straka, Christian
A1  - Brighen, Sara
A1  - Gramatzki, Martin
A1  - Larocca, Alessandra
A1  - Lokhorst, Henk
A1  - Magarotto, Valeria
A1  - Morabito, Fortunato
A1  - Dimopoulos, Meletios A.
A1  - Einsele, Hermann
A1  - Sonneveld, Pieter
A1  - Palumbo, Antonio
T1  - European Myeloma Network recommendations on the evaluation and treatment of newly diagnosed patients with multiple myeloma
JF  - Haematologica
N2  - Multiple myeloma management has undergone profound changes in the past thanks to advances in our understanding of the disease biology and improvements in treatment and supportive care approaches. This article presents recommendations of the European Myeloma Network for newly diagnosed patients based on the GRADE system for level of evidence. All patients with symptomatic disease should undergo risk stratification to classify patients for International Staging System stage (level of evidence: 1A) and for cytogenetically defined high-versus standard-risk groups (2B). Novel-agent-based induction and up-front autologous stem cell transplantation in medically fit patients remains the standard of care (1A). Induction therapy should include a triple combination of bortezomib, with either adriamycin or thalidomide and dexamethasone (1A), or with cyclophosphamide and dexamethasone (2B). Currently, allogeneic stem cell transplantation may be considered for young patients with high-risk disease and preferably in the context of a clinical trial (2B). Thalidomide (1B) or lenalidomide (1A) maintenance increases progression-free survival and possibly overall survival (2B). Bortezomib-based regimens are a valuable consolidation option, especially for patients who failed excellent response after autologous stem cell transplantation (2A). Bortezomib-melphalan-prednisone or melphalan-prednisone-thalidomide are the standards of care for transplant-ineligible patients (1A). Melphalan-prednisone-lenalidomide with lenalidomide maintenance increases progression-free survival, but overall survival data are needed. New data from the phase III study (MM-020/IFM 07-01) of lenalidomide-low-dose dexamethasone reached its primary end point of a statistically significant improvement in progression-free survival as compared to melphalan-prednisone-thalidomide and provides further evidence for the efficacy of lenalidomide-low-dose dexamethasone in transplant-ineligible patients (2B).
KW  - undetermined significance MGUS
KW  - stem-cell transplantation
KW  - multiparameter flow-cytpmetry
KW  - bortezomib plus dxamethasone
KW  - monoclonal gammopathy
KW  - randomized phase-3 trial
KW  - elderly patients
KW  - thalidomide maintenance
KW  - cereblon expression
KW  - autologous transplantation
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117477
VL  - 99
IS  - 2
ER  -