Encinas, C. (Cristina)
- Publications
- item.page.relationships.isContributorAdvisorOfPublication
- item.page.relationships.isContributorOfPublication
6 results
Search Results
Now showing 1 - 6 of 6
- Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature(2019) Cedena, M.T. (María Teresa); Martínez-López, J. (Joaquín); Gironella, M. (Mercedes); Martin, J. (Jesus); Bladé, J. (Joan); Ocio, E.M. (Enrique M.); Gonzalez, Y. (Yolanda); Mateos, M.V. (María Victoria); Arriba, F. (Felipe) de; Encinas, C. (Cristina); Hernandez, M.T. (Miguel Teodoro); Rosiñol, L. (Laura); Puig, N. (Noemí); Cabrera, C. (Carmen); Palomera, L. (Luis); Lahuerta, J.J. (Juan José); Gutierrez, N.C. (Norma C.); Rodriguez-Otero, P. (Paula); Teruel, A.I. (Ana Isabel); Paiva, B. (Bruno); Oriol, A. (Albert); Bengoechea, E. (Enrique); Bargay, J. (Joan); Pérez-de-Oteyza, J. (Jaime); Martínez, R. (Rafael); Nuñez-Cordoba, J.M. (Jorge M.); San-Miguel, J.F. (Jesús F.)Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressing within the first 5 years. Hemoglobin (Hb) >= 12 g/dl (OR 2.74, p = 0.001) and MGUS-like profile (OR 4.18, p = 0.005) were the two baseline variables associated with long-term disease-free survival. Upon including depth of response (and MRD), Hb >= 12 g/dl (OR 2.27) and MGUS-like signature (OR 7.48) retained their predictive value along with MRD negativity (OR 5.18). This study shows that despite the use of novel agents, the probability of disease control at 5 years is still restricted to a small fraction (18.6%) of elderly MM patients. Since this endpoint is associated with higher rates of OS, this study provides important information about diagnostic and post-treatment biomarkers helpful in predicting the likelihood of disease control at 5 years.
- Minimal residual disease monitoring and immune profiling using second generation flow cytometry in elderly multiple myeloma(American Society of Hematology, 2016) Cedena, M.T. (María Teresa); Montero, J. (Juan); Martínez-López, J. (Joaquín); Gironella, M. (Mercedes); Martin, J. (Jesus); Bladé, J. (Joan); Orfao, A. (Alberto); Vidriales, M.B. (María Belén); Ocio, E.M. (Enrique M.); Gonzalez, Y. (Yolanda); Martin-Ramos, M.L. (Maria Luisa); Mateos, M.V. (María Victoria); Encinas, C. (Cristina); Hernandez, M.T. (Miguel Teodoro); Rosiñol, L. (Laura); Puig, N. (Noemí); Arana, P. (Paula); Cabrera, C. (Carmen); Cordón, L. (Lourdes); Lahuerta, J.J. (Juan José); Gutierrez, N.C. (Norma C.); Dongen, J.J.M. (Jacques J. M.) van; Teruel, A.I. (Ana Isabel); Paiva, B. (Bruno); Oriol, A. (Albert); Bargay, J. (Joan); Martínez, R. (Rafael); San-Miguel, J.F. (Jesús F.); Echeveste, M.A. (Maria Asuncion)The value of minimal residual disease (MRD) in multiple myeloma (MM) has been more frequently investigated in transplant-eligible than elderly patients. Since an optimal balance between treatment efficacy and toxicity is of utmost importance in elderly MM, sensitive MRD monitoring might be particularly valuable in this patient population. Here, we used 2nd generation 8-color multiparameter-flow-cytometry (MFC) to monitor MRD in 162 transplant-ineligible MM patients enrolled in the PETHEMA/GEM2010MAS65 study, The transition from 1st to 2nd generation MFC resulted in increased sensitivity, and allowed to identify three patient groups according to MRD levels: MRD-negative (<10-5; n=54, 34%), MRD-positive between <10-4 and ≥10-5 (n=20, 12%), and MRD-positive ≥10-4 (n=88, 54%). MRD status was an independent prognostic factor for time-to progression (-TTP- HR:2.7; P=.007) and overall survival (-OS- HR:3.1; P=.04) with significant benefit for MRD-negative patients (median TTP not reached, 70% OS at 3-years), and similar poorer outcomes for cases with MRD levels between <10-4 and ≥10-5 vs ≥10-4 (both median TTP of 15 months; 63% and 55% OS at 3-years). Furthermore, MRD-negativity significantly improved TTP of patients >75-years (HR:4.8; P<.001), and those with high-risk cytogenetics (HR:12.6; P=.01). Using 2nd generation MFC, immune profiling concomitant to MRD monitoring also contributed to identify patients with poor, intermediate and favorable outcome (25%, 61% and 100% OS at 3-years; P=.01); the later patients being characterized by an increased compartment of mature B-cells. Our results show that similarly to transplant-candidates, MRD monitoring is one of the most relevant prognostic factors in elderly MM, irrespectively of patients’ age and cytogenetic risk.
- Daratumumab, carfilzomib, and dexamethasone in relapsed or refractory myeloma: final analysis of PLEIADES and EQUULEUS(2023) Moreau, P. (Philippe); Chari, A. (Ajai); Martínez-López, J. (Joaquín); Yang, S. (Shiyi); Wang, J. (Jianping); Tarantolo, S. (Stefano); Salwender, H. (Hans); Ailawadhi, S. (Sikander); Mateos, M.V. (María Victoria); Rubia-Comos, J. (Javier) de la; Qi, M. (Ming); Terebelo, H. (Howard); Karlin, L. (Lionel); Encinas, C. (Cristina); Hulin, C. (Cyrille); Rosiñol, L. (Laura); Delioukina, M. (Maria); Benboubker, L. (Lotfi); Touzeau, C. (Cyrille); Rodriguez-Otero, P. (Paula); Goldschmidt, H. (Hartmut); Oriol, A. (Albert); Kosh, M. (Michele); Bargay, J. (Joan); Sureda-Balari, A. (Anna); Haenel, M. (Mathias); Nnane, I. (Ivo); Besemer, B. (Britta)
- Multiple myeloma and SARS-CoV-2 infection: clinical characteristics and prognostic factors of inpatient mortality(2020) Blanchard, M.J. (María Jesús); Casado, L.F. (Luis Felipe); Prieto, E. (Elena); Martínez-López, J. (Joaquín); Krsnik, I. (Isabel); Gironella, M. (Mercedes); Bladé, J. (Joan); Lopez-de-la-Guía, A. (Ana); Mateos, J.J. (Juan José); Mateos, M.V. (María Victoria); Encinas, C. (Cristina); Hernández-Rivas, J.Á. (José Ángel); Senin, M.A. (María Alicia); Escalante, F. (Fernando); Fernández-de-Larrea, C. (Carlos); de-la-Cruz, J. (Javier); Giménez, E. (Eugenio); Lahuerta, J.J. (Juan José); Caminos, N. (Nerea); de-la-Puerta, J.E. (José Enrique); Conde, D. (Diego); Sureda-Balari, A. M. (Anna Maria); Riaza-Grau, R. (Rosalía); Martínez-Barranco, P. (Pilar); San-Miguel, J.F. (Jesús F.)There is limited information on the characteristics, prognostic factors, and outcomes of patients with multiple myeloma (MM) hospitalized with COVID-19. This retrospective case series investigated 167 patients reported from 73 hospitals within the Spanish Myeloma Collaborative Group network in March and April, 2020. Outcomes were compared with 167 randomly selected, contemporary, age-/sex-matched noncancer patients with COVID-19 admitted at six participating hospitals. Among MM and noncancer patients, median age was 71 years, and 57% of patients were male; 75 and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity was moderate–severe in 77 and 89% of patients and critical in 8 and 4%, respectively. Supplemental oxygen was required by 47 and 55% of MM and noncancer patients, respectively, and 21%/9% vs 8%/6% required noninvasive/invasive ventilation. Inpatient mortality was 34 and 23% in MM and noncancer patients, respectively. Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors on adjusted multivariate analysis. This case series demonstrates the increased risk and identifies predictors of inpatient mortality among MM patients hospitalized with COVID-19.
- Lenalidomide and dexamethasone with or without clarithromycin in patients with multiple myeloma ineligible for autologous transplant: a randomized trial(Springer Nature, 2021) Puig, N. (Noemí); Hernandez, M.T. (Miguel Teodoro); Rosiñol, L. (Laura); González, M.E. (María Esther); Arriba, F. (Felipe) de; Oriol, A. (Albert); Gonzalez-Calle, V. (Veronica); Escalante, F. (Fernando); Rubia, J. (Javier) de la; Gironella, M. (Mercedes); Ríos-Tamayo, R. (Rafael); García-Sánchez, R. (Ricarda); Arguiñano, J.M. (José María); Alegre, A. (A.); Martin, J. (Jesus); Gutierrez, N.C. (Norma C.); Calasanz-Abinzano, M.J. (Maria Jose); Martin-Ramos, M.L. (Maria Luisa); Couto, M.C. (María del Carmen); Casanova, M. (María); Arnao, M. (Mario); Pérez-Persona, E. (Ernesto); Garzón, S. (Sebastián); González, M.S. (Marta Sonia); Martín-Sánchez, G. (Guillermo); Ocio, E.M. (Enrique M.); Coleman, M. (Morton); Encinas, C. (Cristina); Vale, A.M. (Ana M.); Teruel, A.I. (Ana Isabel); Cortés-Rodríguez, M. (María); Paiva, B. (Bruno); Cedena, M.T. (María Teresa); San-Miguel, J.F. (Jesús F.); Lahuerta, J.J. (Juan José); Bladé, J. (Joan); Niesvizky, R. (Ruben); Mateos, M.V. (María Victoria)Although case-control analyses have suggested an additive value with the association of clarithromycin to continuous lenalidomide and dexamethasone (Rd), there are not phase III trials confirming these results. In this phase III trial, 286 patients with MM ineligible for ASCT received Rd with or without clarithromycin until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). With a median follow-up of 19 months (range, 0–54), no significant differences in the median PFS were observed between the two arms (C-Rd 23 months, Rd 29 months; HR 0.783, p = 0.14), despite a higher rate of complete response (CR) or better in the C-Rd group (22.6% vs 14.4%, p = 0.048). The most common G3–4 adverse events were neutropenia [12% vs 19%] and infections [30% vs 25%], similar between the two arms; however, the percentage of toxic deaths was higher in the CRd group (36/50 [72%] vs 22/40 [55%], p = 0.09). The addition of clarithromycin to Rd in untreated transplant ineligible MM patients does not improve PFS despite increasing the ≥CR rate due to the higher number of toxic deaths in the CRd arm. Side effects related to overexposure to steroids due to its delayed clearance induced by clarithromycin in this elderly population could explain these results. The trial was registered in clinicaltrials.gov with the name GEMCLARIDEX: Ld vs BiRd and with the following identifier NCT02575144. The full trial protocol can be accessed from ClinicalTrials.gov. This study received financial support from BMS/Celgene.
- The current role of the heavy/light chain assay in the diagnosis, prognosis and monitoring of multiple myeloma: an evidence-based approach(MDPI, 2021) Ríos-Tamayo, R. (Rafael); Puig, N. (Noemí); Algarín, M. (Macarena); García-de-Veas-Silva, J.L. (José Luís); Barbosa, N. (Nuno); Encinas, C. (Cristina); Hernández-Rivas, J.Á. (José Ángel); Alonso, R. (Rafael); Campos, M.L. (María Luisa); Rodríguez, T. (Teresa); Leivas, A. (Alberto); Olivares, M.J. (María José); Sánchez, M.J. (María-José); Paiva, B. (Bruno); Lahuerta, J.J. (Juan José); Martínez-López, J. (Joaquín)Despite tremendous progress being made in recent years, multiple myeloma (MM) remains a challenging disease. The laboratory plays a critical role in the overall management of patients. The diagnosis, prognosis, clinical monitoring and evaluation of the response are key moments in the clinical care process. Conventional laboratory methods have been and continue to be the basis of laboratory testing in monoclonal gammopathies, along with the serum free light chain test. However, more accurate methods are needed to achieve new and more stringent clinical goals. The heavy/light chain assay is a relatively new test which can overcome some of the limitations of the conventional methods for the evaluation of intact immunoglobulin MM patients. Here, we report an update of the evidence accumulated in recent years on this method regarding its use in MM.