Lenalidomide can induce long-term responses in patients with multiple myeloma relapsing after multiple chemotherapy lines, in particular after allogeneic transplant

• Published in: Leukemia & lymphoma 2011-07, Vol.52 (7), p.1262-1270
• Main Authors: Spina, Francesco, Montefusco, Vittorio, Crippa, Claudia, Citro, Annalisa, Sammassimo, Simona, Olivero, Barbara, Gentili, Silvia, Galli, Monica, Guglielmelli, Tommasina, Rossi, Davide, Pia falcone, Antonietta, Grasso, Mariella, Patriarca, Francesca, De muro, Marianna, Corradini, Paolo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Cytogenetics; Dexamethasone - administration & dosage; Dexamethasone - therapeutic use; Humans; Immunoglobulin Isotypes - immunology; Lenalidomide; long-term response; Middle Aged; Multiple Myeloma - drug therapy; Multiple Myeloma - immunology; Multiple Myeloma - mortality; Multiple Myeloma - therapy; Myeloma; Recurrence; Stem Cell Transplantation; Survival Analysis; Thalidomide - analogs & derivatives; Thalidomide - therapeutic use; Time Factors; Transplantation, Homologous; Treatment Outcome
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2011.564695

Evidence of long-term response to lenalidomide in heavily pretreated patients with multiple myeloma is lacking. This study sought to assess whether long-term responders exist, long-term responders' characteristics, and predictive factors of a long-term response. One hundred and four patients with multiple myeloma treated with lenalidomide and dexamethasone after ≥2 therapy lines (median, 3) were analyzed. Long-term response was defined as at least a partial response (≥PR) lasting ≥12 months. The overall response rate was 73%, and 80.3% of the responses were achieved within 5 months. The median response was 14.3 months. Patients evaluable for long-term response numbered 87, and a total of 47% were long-term responders. Compared to non-long-term responders, long-term responders had better overall survival, less light-chain multiple myeloma, and higher incidence of t(11;14). Previous allogeneic transplant (alloSCT) and the response quality predicted a long-term response. In conclusion, patients treated with lenalidomide can become long-term responders; alloSCT and response quality predict long-term response.