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Allografting

A prospective study of lenalidomide monotherapy for relapse after Allo-SCT for multiple myeloma

Bone Marrow Transplantation volume 49, pages 492–495 (2014)Cite this article

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Abstract

Allo-SCT can result in long-term remission in patients with multiple myeloma (MM), although its overall role in disease management remains controversial. We evaluated lenalidomide monotherapy response and tolerability among 18 patients with MM who progressed or relapsed after Allo-SCT, who were enrolled a median of 12 months (range 3–104) following transplant. Treatment duration of lenalidomide was 8 months (range 1–57). Ten patients required dose reductions from 25 to 5–20 mg at a median of three cycles (range 1–12): eight for neutropenia, one for thrombocytopenia and one for myalgias and weakness. Serious adverse events (N=5) included H1N1 influenza (2), bacterial pneumonia (2) and fever, myalgia and hypoxia. Two patients died at 3 and 5 months of gastrointestinal or hepatic GVHD occurring within 1 month of dosing. Responses included complete response (CR) (5), very good partial response (2), partial response (PR) (3), minimal response (1) and stable disease (2) for an overall response rate (⩾PR) of 56%. Ten patients discontinued therapy for progressive disease (PD) at a median of 8.5 (1–43) months. Six patients died from PD. Five patients remained on therapy at 39 months (range 14–57), with four in CR. Lenalidomide for relapse of MM after Allo-SCT can result in extended disease control (>12 months) in 50% of patients.

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Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    W I Bensinger, D J Green, N Burwick & P S Becker

  2. Department of Medicine, University of Washington, Seattle, WA, USA

    W I Bensinger, D J Green, N Burwick & P S Becker

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  1. W I Bensinger
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  2. D J Green
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  3. N Burwick
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  4. P S Becker
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Correspondence to W I Bensinger.

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Competing interests

William Bensinger received research funding from Celgene for this trial. He has served as an advisor and a speaker for Celgene. Pam Becker has received research funding from Celgene. Nicholas Burwick and Damian Green report no conflicts of interest.

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Author contributions

WIB designed the study, analyzed the data and wrote the manuscript. PSB analyzed the data and edited the manuscript. DJG and NB edited the manuscript.

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Bensinger, W., Green, D., Burwick, N. et al. A prospective study of lenalidomide monotherapy for relapse after Allo-SCT for multiple myeloma. Bone Marrow Transplant 49, 492–495 (2014). https://doi.org/10.1038/bmt.2013.219

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