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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1436587
End-of-life management of multiple myeloma patients in the era of CD38 and immunotherapy
Provisionally accepted- 1 Hospices Civils de Lyon, Lyon, Rhône-Alpes, France
- 2 Université Claude Bernard Lyon 1, Lyon, France
In spite of spectacular advances in the treatment of multiple myeloma, a majority of patients will die from this disease or related complications. While a great amount of focus has been dedicated to the development of novel therapies, little attention has been paid to latter stages of patient follow-up.In order to describe patient management during this critical period as well as the immediate causes and circumstances of death, we have analyzed a single center series of 100 patients diagnosed with myeloma who died between 2016 and 2021.Patients received a median of 3 lines of treatment, including 2 during their last year of life. Sixty per cent of patients had received daratumumab. Fifty patients had obtained complete remission or very good partial response at some time during the course of disease but 75 were refractory to the last treatment line. Eighteen patients died while their disease was stable or in remission while 77 had confirmed progressive disease at time of death. Thirty six patients had uncontrolled sepsis, 49 were in renal failure and 24 had hypercalcemia at the time of death. Seventy three patients presented with lymphopenia. Disease progression was documented in a majority of MM patients at the time of death and was associated with disease-related complications in a significant number of patients.Disease progression remains the main cause of death in patients with multiple myeloma.
Keywords: Myeloma, CD38 targeted therapies, End of Life, Management, Curative and prophylactic therapies
Received: 22 May 2024; Accepted: 07 Oct 2024.
Copyright: © 2024 Sesques, Karlin, Massy, Maarek, Aussedat, Lazareth, Golfier, Bouafia-Sauvy, Lequeu, Ghergus, Safar, Ferrant, BACHY, GHESQUIERES, Confavreux, Demangel, Perrial and Dumontet. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Charles Dumontet, Université Claude Bernard Lyon 1, Lyon, France
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