OTOLOG KÖK HÜCRE NAKLİ UYGULANMAYAN MULTİPL MYELOM HASTALARINDA TEDAVİ SONRASI SAĞKALIM VERİLERİ

Giriş: Multipl Myelom (MM) hastalarında yüksek doz tedavi sonrası otolog hematopoietik kök hücre nakli (OHKHN) uygun hastalarda standart tedavi haline gelmiştir. Ancak farklı sebeplerle OHKHN için uygun olmayan hastalar bulunmaktadır. Biz de merkezimizde MM tanısı ile takip edilen ve OHKHN uygulanmayan hastalarımızın genel sağkalım ve progresyonsuz sağkalım verilerini elde etmeyi amaçladık. Gereç ve Yöntem: 2010-2020 yılları arasında Sa ğlık Bilimleri Üniversitesi İzmir Bozyaka Eğitim ve Araştırma Hastanesi hematoloji bilim dalında takip ve tedavisi yapılan ve OHKHN uygulanmamış MM tan ılı 62 hasta yer aldı. Veriler geriye dönük dosya sistemi üzerinden tarandı. Bulgular: 62 MM tanılı hastadan 33’ü kadın 29’u erkekti. Medyan tanı yaşı 72 olarak saptandı. ISS evreleme sistemine göre değerlendirildiğinde 13 hasta (% 20.9) ISS evre I, 26 hasta (% 41.9) ISS evre II, 23 hasta (% 37.0) ISS evre III olarak değerlendirilmiştir. İlk basamak tedavide hastaların 47‘sinde (%75.8) bortezomib içeren bir rejim tercih edilmiştir. Hastaların 25’i (%40.3) tedaviye tam yanıt, 5’i (%8.0) çok iyi kısmi yanıt, 11’i (%17.7) parsiyel yanıt ve 14’ü (%22.5) yanıtsız olarak değerlendirilmiştir. 7 hasta tedavi sırasında öldüğünden dolayı yanıt değerlendirilmesine alınamamıştır. Nakil olmayan MM hasta gurubunda 10 y ıllık takipte genel sa ğkalım; 1. yıl %80,6 ±05,0 , 2. y ıl %72,2 ±05,7, 5. y ıl %52,2 ±07,5, 10. y ıl %22,6 ±09,9 olarak bulunmuştur.Progresyonsuz sağkalım 1. yıl %80,6 ±05,0, 2. yıl %67,0 ±06,1, 5. yıl %08,0 ±05,2 olarak bulunmuştur. Sonuç: MM heterojen bir hastalıktır ve tedavi hasta özelliklerine göre bireyselleştirilmelidir. Yaş ve komorbiditeler gibi farklı sebepler ilaç seçimini etkilemektedir. Günümüzde yeni tanı hastada standartlaşan OHKHN tedavisi özellikle ya şlı hastaların ço ğunda uygun tedavi seçeneği olamamaktadır ve hastalar geleneksel kemoterapi tedavisi almaktadır. Geleneksel kemoterapi ile tedavi edilen hastalarda sağkalımı etkileyen birçok farklı sebep bulunmaktadır.

SURVIVAL DATA AFTER TREATMENT IN MULTIPL MYELOMA PATIENTS NOT UNDERGOING AUTOLOGOUS STEM CELL TRANSPLANTATION

Introduction: Autologous hematopoietic stem cell transplantation (AHSCT) has become the appropriate standard treatment after high-dose therapy in patients with Multiple Myeloma (MM). However, there are patients who are not suitable for AHSCT for different reasons. We aimed to achieve overall survival and progression-free survival of our patients who were followed up with a diagnosis of MM in our center and did not undergo AHSCT. Material and Method: There were 62 patients with a diagnosis of MM who were followed up and treated in the hematology department of Health Sciences University Izmir Bozyaka Training and Research Hospital between 2010 and 2020 and who did not undergo AHSCT. The data were scanned retrospectively through the file system. Results: 33 of 62 MM patients were female and 29 were male. Median age at diagnosis was 72 years. When evaluated according to the ISS staging system, 13 patients (20.9%) were classified as ISS stage I, 26 patients (41.9%) as ISS stage II, and 23 patients (37.0%) as ISS stage III. In the first-line treatment, a regimen containing bortezomib was preferred in 47 (75.8%) of the patients. Of the pat ients, 25 (40.3%) were evaluated as complete response to treatment, 5 (8.0%) as very good partial response, 11 (17.7%) partial response and 14 (22.5%) unresponsive. Response could not be evaluated because 7 patients died during treatment. Overall survival at 10- year follow-up in non-transplant MM patient group; It was found to be 80.6 ± 05.0% in the first year, 72.2 ± 05.7% in the second year, 52.2 ± 07.5% in the 5th year, 22.6 ± 09.9% in the 10th year. Progression-free survival was found to be 80.6 ± 05.0% at the 1st year, 67.0 ± 06.1% at the 2nd year, and 08.0 ± 05.2% at the 5th year. Conclusion: MM is a heterogeneous disease and treatment should be individualized according to patient characteristics. Different reasons such as age and comorbidities affect the choice of medication. Nowadays, the standardized treatment of AHSCT in newly diagnosed patients is not suitable for most of the elderly patients and patients receive traditional chemotherapy. There are many different reasons affecting survival in patients treated with conventional chemotherapy.

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