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首页> 外文期刊>Sao Paulo Medical Journal >Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study
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Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study

机译：多发性骨髓瘤的血液学方法：来自巴西血液学家的一种趋势。横断面研究

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CONTEXT AND OBJECTIVE: For the last nine years, hematologists and oncologists have gathered annually at an educational symposium organized by a Brazilian and an American hospital. During the 2015 Board Review, a survey among the attendees evaluated the differences in management and treatment methods for multiple myeloma (MM). DESIGN AND SETTING: Cross-sectional study during an educational hematology symposium in S?￡o Paulo, Brazil. METHODS: Hematologists present at the symposium gave responses to an electronic survey by means of mobile phone. RESULTS: Among the 350 attendees, 217 answered the questionnaire. Most of the participants believed that immunotargeting agents (iTA) might be effective for slowing MM progression in heavily pretreated patients (67%) and that continued exposure to therapy might lead to emergence of resistant clones in patients with MM (76%). Most of the physicians use maintenance therapy after hematopoietic stem cell transplantation (95%) and 45% of them would further restrict it to post-transplantation patients with underlying high-risk disease. The first-line drugs used for transplantation-ineligible patients (TI-MM) were bortezomib-thalidomide-dexamethasone (31%), bortezomib-dexamethasone (28%), lenalidomide-dexamethasone (Rd; 17%) and melphalan-based therapy (10%). Lenalidomide was the drug of choice for post-transplantation maintenance for half of the participants. No significant differences were observed regarding age or length of experience. CONCLUSION: The treatment choices for TI-MM patients were highly heterogenous and the melphalan-based regimen represented only 10% of the first-line options. Use of maintenance therapy after transplantation was a common choice. Some results from the survey were divergent from the evidence in the literature.
机译：背景与目的：在过去的九年中，血液学家和肿瘤学家每年都在巴西和美国一家医院举办的教育研讨会上聚会。在2015年董事会审查期间，与会者之间的一项调查评估了多发性骨髓瘤（MM）的管理和治疗方法的差异。设计与环境：在巴西圣保罗举行的血液学教育研讨会上进行的横断面研究。方法：出席研讨会的血液学家通过手机对电子调查做出了回应。结果：在350位参与者中，有217位回答了问卷。大多数参与者认为，免疫靶向剂（iTA）可以有效减缓经过大量治疗的患者的MM进展（67％），并且持续接触治疗可能导致MM患者出现耐药克隆（76％）。多数医生在造血干细胞移植后使用维持疗法（95％），其中45％的医师将进一步限制其用于具有潜在高危疾病的移植后患者。适用于不适合移植的患者（TI-MM）的一线药物是硼替佐米-沙利度胺-地塞米松（31％），硼替佐米-地塞米松（28％），来那度胺-地塞米松（Rd; 17％）和基于美法仑的治疗（ 10％）。来那度胺是用于一半参与者的移植后维持治疗的首选药物。在年龄或经验长度方面未观察到显着差异。结论：TI-MM患者的治疗选择高度异质，以美法仑为基础的治疗方案仅占一线治疗方案的10％。移植后使用维持疗法是常见的选择。调查的一些结果与文献中的证据有所不同。

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