Open AccessThe role of pomalidomide in treatment of relapse and refractory multiple myeloma
Author(s) -
S. Voloshin,
Sergey Linnikov,
А Д Гарифуллин,
Anastasiya Kuzyaeva,
А. В. Шмидт,
Alexey Kuvshinov,
А Н Богданов,
M. A. Mikhileva,
Irina Martynkevich,
Marina Zenina,
Sergey Sidorkevich
Publication year - 2022
Publication title -
onkogematologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.118
H-Index - 3
eISSN - 2413-4023
pISSN - 1818-8346
DOI - 10.17650/1818-8346-2022-17-1-26-36
Subject(s) - pomalidomide , multiple myeloma , dexamethasone , medicine , lenalidomide , oncology , bortezomib , adverse effect , daratumumab
Background . Over the past 15 years, the therapeutic breakthrough in the treatment of multiple myeloma observed primarily due to the emergence of new drugs. Since the characteristic of the disease is a chronic course with consecutive periods of remissions and relapses, the search for new effective treatment options with each subsequent relapse/progression is critical to increasing the survival of patients. Objective : to evaluate the role of pomalidomide in the treatment of relapsed/refractory multiple myeloma. Materials and methods . The results’ analysis of using pomalidomide-based treatment (Pd (pomalidomide/dexamethasone), PVd (pomalidomide/bortezomib/dexamethasone), KPd (carfilzomib/pomalidomide/dexamethasone), IxaPd (ixazomib/pomalidomide/dexamethasone), DaraPd (daratumumab/pomalidomide/dexamethasone), IsaPd (isatuximab/ pomalidomide/dexamethasone), EloPd (elotuzumab/pomalidomide/dexamethasone)) in pretreated patients, including own data, was done. Based on the RosNIIGT FMBA of Russia, 17 patients with relapsed/refractory multiple myeloma were treated; the frequency of achieving a response and the development of adverse events was estimated; the possibility of pomalidomide dose reducing with the development of adverse events was described without an apparent decrease of effectiveness. Results. The frequency of the overall response in using pomalidomide-based programs was 53 % (according to the world data, from 38 to 82 %). This drug is recommended for patients with multiple myeloma, even accompanied by the final stages of renal failure. The most frequent adverse event was grade III–IV neutropenia (30 % of patients). In 3 patients, the dosage of pomalidomide was adjusted with a decrease to 2 mg per day. In 2 patients, therapy was discontinued due to pulmonary embolism and bilateral pneumonia. After three courses of DaraPd, one patient achieved a complete response and underwent autologous hematopoietic stem cell transplantation. Conclusion . Pomalidomide-based programs in patients with relapsed/refractory multiple myeloma are an effective treatment option. Using dose-adjusted pomalidomide after the occurrence of neutropenia makes it possible to normalize the neutrophils level (more than 1 × 109/l) and continue anti-myeloma therapy, preserving the therapeutic effect and in individual patients with unfavorable prognosis factors to conduct high-dose therapy followed by autologous hematopoietic stem cell transplantation.