Abstract
this difference in outcomes may reflect differences in adrenal suppression, we studied patients from our myeloma database. Early morning serum cortisol levels at baseline and again at 3 months were determined to compare adrenal function in patients with MM receiving either lowor high-dose dexamethasone. At baseline, 8 AM serum cortisol levels were not different between the groups. At 3 months, 72.7% of the high-dose group had a decline in their 8 AM cortisol levels compared to 32.4% of the low-dose group (P = .03). The proportion of patients with a 3-month 8 AM serum cortisol level below 3 mcg/dL, a level considered to be presumptive evidence of adrenal suppression, was also increased in the high dose group (45.5% vs. 8.8%; P = .01). Overall, the high-dose dexamethasone group experienced a mean decline of 6.4 mcg/dL in their 8 AM serum cortisol levels after 3 months (95% CI, –10.7 to –2.1), while the low-dose group demonstrated no significant change (95% CI, –0.2 to 4.3). Additional studies are needed to determine the impact of corticosteroid-induced adrenal insufficiency on important treatment outcomes such as symptom relief and prognosis.
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