Untersuchung zur Remissionstiefe von transplantationsfähigen Patienten mit multiplem Myelom nach Erstlinieninduktionstherapie – eine retrospektive Kohortenanalyse
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Philipps-Universität Marburg
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Abstract
The introduction of new agents in the treatment of Newly Diagnosed Multiple
Myeloma (NDMM) has significantly improved the prognosis and outcome of
patients eligible for transplantation. Increasingly, patients are treated within
clinical trials, which usually involves therapy in clinical centres or teaching
hospitals. The objective of this work was to find out whether the teaching status
of the hospital has an impact on remission and stem cell apheresis in myeloma
patients.
We examined data from 184 myeloma patients who had received their first
autologous stem cell transplant at the Universitätsklinikum Gießen und Marburg,
Marburg site (UKGM) between 2012 and 2020. The patients were divided into 3
cohorts according to the site where the induction therapy was performed: UKGM,
Teaching-hospital Fulda and referring physicians from the SHI system, so-called
"office-based physicians". In addition, we compared patients who had received
their induction therapy within a clinical trial with patients who had not been
included in any clinical trial. We examined the remission status after receiving induction therapy and before stem cell transplantation, as well as the number of
stem cells collected.
The patients in the UKGM group showed significantly lower remissions than those
in the other two cohorts. Since clinical trials were increasingly conducted at the
university institute, while the patients of the two referral cohorts received induction
therapy outside of such studies, with one exception, we attribute this observation
primarily to the use of more aggressive agents. This can also be confirmed by the
fact that comparing patients with and without clinical trials within the UKGM
cohort, a significant difference in the depth of remission was detectable. When
the patients with clinical trials were excluded, there was no longer any evidence
of siginificance between the UKGM group and the other two cohorts.
The overall population showed a tendency towards deeper remissions over the
study period, which could also be observed when considering trial patients and
patients without clinical trial separately. We attribute this to the fact that the
therapy regimens have also generally become more aggressive.
The amount of collected stem cells at the UKGM was between the numbers of
the two other cohorts. However, trial patients showed a significantly lower amount
of collected stem cells than patients without clinical trial. Over the period
considered, the average number of CD34+ cells collected in the total cohort has
approximately halved. This leads to the observation that remission status and
stem cell apheresis are moving in opposite directions due to the increasing use
of new agents.
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Dates
Created: 2023Issued: 2023-09-19Updated: 2023-09-19
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
RemissionstiefeStammzellaphereseDepth of remissionstem-cell apheresis
DFG-subjects
Multiples Myelom
DDC-Numbers
610
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Moser, Caroline: Untersuchung zur Remissionstiefe von transplantationsfähigen Patienten mit multiplem Myelom nach Erstlinieninduktionstherapie – eine retrospektive Kohortenanalyse. : Philipps-Universität Marburg 2023-09-19. DOI: https://doi.org/10.17192/z2023.0455.
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This item has been published with the following license: In Copyright