Progression free survival, overall survival and www.selleckchem.com/products/sbe-b-cd.html duration of response
were estimated according to the Kaplan-Meier method. We used the Cox proportional hazards regression model to this website estimate hazard ratios and 95% CIs. Differences between survival curves were tested for statistical significance with the two-sided log-rank test. Patients A total of 17 patients with IgD MM was identified, patients characteristics are listed in Table 1. The median age of the patients was 55-years (range 37-78); 8/17 patients had ECOG performance scores > 2 and 14 had ≥ 1 lytic bone lesions. Eight patients (47%) had renal impairment with estimated glomerular filtration rate (eGFR) < 50 ml/min, one patient had hypercalcemia (serum calcium concentration ≥ 12 mg/dl), 11 patients had lambda light chains (64%) and Bence-Jones proteinuria
in 70%. BTK inhibitor Five patients were of stage III according to ISS; cytogenetic analysis by fluorescence in situ hybridization (FISH) was possible in six of eleven patients and the abnormalities are shown in Table 2. Only one patient was positive for amyloidosis at baseline. Table 1 Patient characteristics at diagnosis Number of patients = 17 Male/Female 11/6 Median Age at diagnosis yr (range) 55 (37-78) years ≤ 65 y = 13 (76.5%), ≥ 65 y = 4 (23.5%) ISS stage at diagnosis I 7 II 2 III 5 Unknown 3 Performance status ECOG < 2 9 ECOG > 2 8 Light chain type k 6 λ 11 Bone marrow infiltration 30% (10-70%) Extra osseous disease 0 Bone lesions 14/17 (82%) Median serum monoclonal protein g/dl 1.05 (0.09-5) Median Urine monoclonal protein g/24 h 0.79 (0-28) Urine immunofixation positive 12/17 (70%) Serum β2 microglobulin > 5.5 mg/L 5/17 (29%) Serum albumin < 3.5 g/dl 5/17 (29%) eGFR < 50 ml/min 8/17 (47%) Serum
Calcium > 12 mg/dl 1/17 Amyloidosis 1/17 Hemoglobin g/dl, median (range) 11.9 (6.5-15) < 10 5/17 (29%) WBC count 109/L, median (range) 6.57 (3.19-16.8) > 7 × 109/L 7/17 (41%) Platelet count 109/L, median (range) 214 (74-518) < 100 × 109/L 1/17 Table 2 Interphase FISH cytogenetic profile results Number of patients = 17 Not available 11 Available 6 del(13q) 1/6 del(6q) 1/6 t(11;14) 2/6 -Y 1/6 +11 1/6 Results Six patients were treated with CT, five with Melphalan plus steroids based regimens and one with VAD (Vincristine, Adriamycin and Dexametasone) Tau-protein kinase plus CED (Cyclophosphamide, Etoposide, Dexamethasone); one patient showed a CR, two VGPR, two PR and one SD. Thalidomide was used as maintenance in the patient who obtained CR after CT. The overall response rate (ORR) was 83%; after a median follow up of 38 months (range 19-60) for patient treated with conventional chemotherapy, the median OS was 34 months (95% CI 15- 54 months) and the median PFS was 18 months (95% CI 3-33 months). Median DOR was 7 months (95% CI 5-9 months). Eleven patients underwent HDT/ASCT, as part of their front line therapy, five patients received single and six tandem ASCT.