An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma

Damian Mikulski; Paweł Robak; Grzegorz Mirocha; Wiktoria Ryżewska; Kamila Stańczak; Karol Okoński; Kacper Kościelny; Tadeusz Robak

doi:10.5114/wo.2023.133506

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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3/2023
vol. 27

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abstract:

Original paper

An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma

Damian Mikulski

^{1, 2}

,

Paweł Robak

^{1, 3}

,

Grzegorz Mirocha

²

,

Wiktoria Ryżewska

³

,

Kamila Stańczak

³

,

Karol Okoński

²

,

Kacper Kościelny

²

,

Tadeusz Robak

^{3, 4}

Department of Hematooncology, Copernicus Memorial Hospital, Comprehensive Cancer Centre and Traumatology, Łódź, Poland
Department of Biostatistics and Translational Medicine, Medical University of Łódź, Łódź, Poland
Department of Hematology, Medical University of Łódź, Łódź, Poland
Department of General Hematology, Copernicus Memorial Hospital, Comprehensive Cancer Centre and Traumatology, Łódź, Poland

Contemp Oncol (Pozn) 2023; 27 (3): 139–146

DOI: https://doi.org/10.5114/wo.2023.133506

Online publish date: 2023/12/06

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AMA

Mikulski D, Robak P, Mirocha G, et al. An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma. Contemporary Oncology/Współczesna Onkologia. 2023;27(3):139-146. doi:10.5114/wo.2023.133506.

APA

Mikulski, D., Robak, P., Mirocha, G., Ryżewska, W., Stańczak, K.,  & Okoński, K. et al. (2023). An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma. Contemporary Oncology/Współczesna Onkologia, 27(3), 139-146. https://doi.org/10.5114/wo.2023.133506

Chicago

Mikulski, Damian, Paweł Robak, Grzegorz Mirocha, Wiktoria Ryżewska, Kamila Stańczak, Karol Okoński,  and Kacper Kościelny et al. 2023. "An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma". Contemporary Oncology/Współczesna Onkologia 27 (3): 139-146. doi:10.5114/wo.2023.133506.

Harvard

Mikulski, D., Robak, P., Mirocha, G., Ryżewska, W., Stańczak, K., Okoński, K., Kościelny, K.,  and Robak, T. (2023). An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma. Contemporary Oncology/Współczesna Onkologia, 27(3), pp.139-146. https://doi.org/10.5114/wo.2023.133506

MLA

Mikulski, Damian et al. "An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma." Contemporary Oncology/Współczesna Onkologia, vol. 27, no. 3, 2023, pp. 139-146. doi:10.5114/wo.2023.133506.

Vancouver

Mikulski D, Robak P, Mirocha G, Ryżewska W, Stańczak K, Okoński K et al. An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma. Contemporary Oncology/Współczesna Onkologia. 2023;27(3):139-146. doi:10.5114/wo.2023.133506.

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Introduction:
The systemic inflammation index (SII) might serve as an indicator of the equilibrium between the inflammatory and immune responses. The aim of the study was to determine the clinical value and prognostic significance of SII in the cohort of multiple myeloma (MM) patients treated with a regimen of pomalidomide and dexamethasone (Pd).

Material and methods:
This retrospective, real-life study included patients who received a Pd regimen in our centre between November 2018 and July 2022. The systemic inflammation index was calculated from peripheral blood counts of platelets, neutrophils, and lymphocytes collected shortly before commencement of Pd treatment using the equation: SII = N x P/L, where N, P, and L are the respective counts per litre of peripheral blood for neutrophils, platelets, and lymphocytes.

Results:
The study group consisted of 54 patients. Most patients received Pd as the third (38.9%) or fourth (37.0%) line of treatment. The median number of completed treatment cycles was 5 (IQR: 1–12). The median progression-free survival (PFS) was 6.8 months and overall survival (OS) 14.8 months. High SII (> 374) was an independent prognostic factor for PFS (HR = 3.0, 95% CI: 1.4–6.3, p < 0.01) and OS (HR = 2.2, 95% CI: 1.0–4.6, p = 0.04). In the low SII group, the respective median PFS and OS values were 9.6 and 21.7 months, compared to 2.6 (p = 0.018) and 5.5 months (p = 0.035) in the high SII group.

Conclusions:
The systemic inflammation index has prognostic significance in MM patients treated with Pd. A high SII predicts a poorer outcome in pretreated MM patients undergoing Pd treatment evaluation. As such, it may well be a key factor for guiding subsequent treatment decisions.

keywords:

An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma

Damian Mikulski 1, 2 , Paweł Robak 1, 3 , Grzegorz Mirocha 2 , Wiktoria Ryżewska 3 , Kamila Stańczak 3 , Karol Okoński 2 , Kacper Kościelny 2 , Tadeusz Robak 3, 4

multiple myeloma, pomalidomide, SII, systemic inflammatory index

Damian Mikulski

^{1, 2}

,

Paweł Robak

^{1, 3}

,

Grzegorz Mirocha

²

,

Wiktoria Ryżewska

³

,

Kamila Stańczak

³

,

Karol Okoński

²

,

Kacper Kościelny

²

,

Tadeusz Robak

^{3, 4}