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Myeloma

Long-term outcome with lenalidomide and dexamethasone therapy for newly diagnosed multiple myeloma

Leukemia volume 27, pages 2062–2066 (2013)Cite this article

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Abstract

The combination of lenalidomide and dexamethasone (Len–Dex) is a commonly used initial therapy for newly diagnosed multiple myeloma (MM). Although the initial response rates and toxicity are well known, long-term outcome is not well described. We studied 286 consecutive patients with newly diagnosed MM initially treated with Len–Dex. The median (range) age at diagnosis was 63 (28–92) years, 166 (58%) patients ⩽65 years and 175 (61%) male. The median estimated duration on Len–Dex was 5.3 months with overall response (⩾partial response) of 72%, including 26% with very good partial response or better. The median overall survival (OS) from the diagnosis was not reached (NR) and the estimated 5-year survival was 71%. The median time to first disease progression, irrespective of transplant status, was 30.2 months. Overall, 143 (50%) patients underwent stem cell transplant. The median OS was NR for patients ⩽70 years and 5.8 years for the older patients (P=0.01). The 5-year OS estimate for patients in International Staging System stage 1, 2 and 3 were 82, 65, and 44% respectively. There were 21 new second malignancies after MM diagnosis (6.6%). The median survival exceeding 7 years reflects the efficacy of novel agents. The risk of second malignancies doesn’t appear to be excessive in this population.

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Acknowledgements

This work was supported in part by Mayo Clinic Hematological Malignancies Program, Paul Calabresi K12 Award (CA96028). Also supported in part by grants CA 107476, CA 62242, CA100707 and CA 83724 from the National Cancer Institute, Rockville, MD, USA, and also supported in part by the Jabbs Foundation, Birmingham, United Kingdom and the Henry J Predolin Foundation, USA.

Author contributions

GS, VR, SK designed the research, collected and analyzed the data, and wrote the manuscript;MQL, FKB, SRH, AD, MAG, DD, SZ, SR, AM, PK, RK, SVR assisted in data collection and manuscript preparation; and all the authors approved the final draft of the manuscript.

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Authors and Affiliations

  1. Division of Hematology and Blood and Marrow Transplant, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    G Srivastava, V Rana, M Q Lacy, F K Buadi, S R Hayman, A Dispenzieri, M A Gertz, D Dingli, S Zeldenrust, S Russell, A McCurdy, P Kapoor, R Kyle, S V Rajkumar & S Kumar

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  1. G Srivastava
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  2. V Rana
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Correspondence to S Kumar.

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Competing interests

AD received research dollars from Celgene, Millenium, Pfizer, MAG received honoraria for lectures from Celgene, RK is on the monitoring committees for Celgene as well as their advisory board for secondary malignancies, SVK received research support for clinical trials form Celgene, Millennium, Novartis, Cephalon, Onyx, consulting Merck, Celgene, Onyx.

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Srivastava, G., Rana, V., Lacy, M. et al. Long-term outcome with lenalidomide and dexamethasone therapy for newly diagnosed multiple myeloma. Leukemia 27, 2062–2066 (2013). https://doi.org/10.1038/leu.2013.143

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