12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
This was still true for the following scales, if patients with progressive
disease were excluded from the analysis: global QOL (p 0.02747),
fatigue (p 0.00017), role functioning (p 0.04032, Figure 1), cognitive functioning
(p 0.0224), and emotional functioning (p 0.01274). When QOL
at the last visit of induction treatment was analyzed, global QOL (p
0.02273), physical functioning (p 0.01541) and fatigue (p 0.004616) were
significantly associated with quality of response. In the case of global
QOL and fatigue this was still true when patients with PD were excluded
(p 0.04991 and p 0.009635, respectively). Mean physical functioning
and cognitive functioning during induction were also inversely correlated
with time to first response (p 0.04025 and p 0.04674, respectively).
Conclusions. Quality of response during induction treatment significantly
influences central parameters of QOL including cognitive function in
myeloma patients undergoing conventional therapy. If patients with
progressive disease are excluded, the magnitude of response is still associated
with QOL. Even if survival cannot be prolonged by achieving a
better response, myeloma patients might benefit from a better response
by having a better quality of life.
0674
SERUM C-REACTIVE PROTEIN IS THE MORE POWERFUL FACTOR PREDICTING OUTCOME
OF MM TREATED WITH ANTRACYCLIN-THALIDOMIDE BASED THERAPY
M. Offidani, 1 , C. Polloni, 2 L. Corvatta, 2 M.N. Piersantelli, 2 P. Galieni, 3
M. Catarini, 3 F. Alesiani, 4 M. Burattini, 5 S. Brunori, 5 A. Samori, 5
N. Blasi, 5 M. Ferranti, 5 P. Leoni2 1 2 Polo Ospedaliero-Universitario Ospedali, ANCONA; Clinica di Ematologia
Polo Ospedaliero-U, ANCONA; 3Divisione Ematologia, ASCOLI PICENO;
4 5 Unità di Oncoematologia, SAN SEVERINO MARCHE; Divisione Medicina,
JESI, Italy
Background. Few studies investigated factors affecting outcome in MM
patients treated with thalidomide-chemotherapy based therapy when
they could be helpful in selecting potentially benefiting patients thus
allowing a risk-based therapy since previous prognostic score (i.e ISS and
others), may not suit new drugs based-therapy. Aims. We investigated
factors affecting response, time to progression (TTP) and overall survival
(OS) in Multiple Myeloma patients (MM) treated with ThaDD
regimen (Thalidomide 100 mg/day, Dexamethasone 40 mg day 1-4, 9-
12, pegylated liposomal doxorubicin 40 mg/mq day 1 every 28 days) in
selecting patients benefiting more from this therapy. Patients and Methods.
One hundred and twenty seven MM patients were treated with
ThaDD regimen. Median age was 71 years (range 41-83); 66 were newly
diagnosed and 61 relapsed/refractory MM, respectively. We analysed
the following variables to search for factors affecting response (≥ VGPR
vs < VGPR), TTP and OS: age (≥ 70 vs < 70), sex, ECOG performance
status (0-1 vs 2-4), MM isotype (IgA vs others), D-S stage I-II vs III),
bone marrow plasmocytosis (″ 50% vs > 50%), haemoglobin (< 10 vs ≥
10 g/dl), platelets (< 100000 vs ≥ 100000/µL), β2-microglobulin (″ 3.5 vs
>3.5 µg/dL), serum albumin (″ 3.5 vs >3.5 mg/dL), ISS (1-2 vs 3), serum
C-reactive protein (normal vs abnormal), serum creatinine (″ 2 vs > 2
mg/dl), FISH cytogenetics abnormalities [unfavourable: del13, t(4;14),
t(14-16), ipodyploid vs normal, hyperdyploid and t(11;14)] disease status
(newly diagnosed vs relapsed-refractory), stem cell transplantation
at diagnosis and time to first progression (the last 2 parameters only for
relapsed/refractory MM). Results. Overall, 69 patients (53%) showed
response, ≥ VGPR median TTP and OS was 23.5 and 35.5 months,
respectively. By univariate analysis, factors positively affecting response
were normal sCRP (73% vs 37%; p