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Impact of early use of lenalidomide and low-dose dexamethasone on clinical outcomes in patients with relapsed/refractory multiple myeloma

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Abstract

We retrospectively investigated the prognostic factor of lenalidomide plus low-dose dexamethasone (Rd) in Japanese patients with refractory or relapsed multiple myeloma (RRMM) registered in the Kansai Myeloma Forum from January 2006 to December 2013. A total of 140 patients were analyzed. The median age was 66 years. The overall response rate was 68.6 %, including 33.1 % with a better than very good partial response. At 13.0 months median follow-up, the median overall survival (OS) and progression-free survival (PFS) were 34.2 and 17.0 months, respectively. In univariate analyses, patients with one or two prior therapies had significantly longer OS (41.2 vs. 21.5 months; P = 0.002) and PFS (29.0 vs. 13.0 months; P = 0.006) than patients treated with three or more prior therapies. Prior use of thalidomide was associated with significantly shorter PFS (19.0 vs. 16.0 months; P = 0.045). The prior use of bortezomib or high-dose therapy with stem cell transplantation, and the International Staging System had no impact on long-term outcome. Multivariate analysis showed that only the number of prior therapies was a significant predictor of both OS and PFS. Our findings suggest that greater benefit may occur when Rd therapy is used at the first or second relapse in RRMM.

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Acknowledgments

We wish to thank all the researchers of the KMF for their scientific support.

Conflict of interest

This work was partly supported by a research fund from the Celgene Corporation (Summit, NJ).

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Authors and Affiliations

  1. Division of Hematology and Oncology, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan

    Tsutomu Kobayashi, Junya Kuroda & Masafumi Taniwaki

  2. Department of Hematology, Japan Community Health Care Organization Kyoto-Kuramaguchi Medical Center, Kyoto, Japan

    Shin-ichi Fuchida & Chihiro Shimazaki

  3. Department of Hematology, Osaka Red Cross Hospital, Osaka, Japan

    Hitomi Kaneko & Mitsuru Tsudo

  4. Department of Hematology, Nara Hospital Kinki University Faculty of Medicine, Nara, Japan

    Hideo Yagi

  5. Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan

    Hirohiko Shibayama & Yuzuru Kanakura

  6. Division of Hematology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kinki University, Higashiosaka, Japan

    Hirokazu Tanaka & Itaru Matsumura

  7. Department of Hematology, Toyonaka Municipal Hospital, Toyonaka, Japan

    Satoru Kosugi

  8. Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan

    Nobuhiko Uoshima & Hitoji Uchiyama

  9. Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan

    Nobuhiko Uoshima

  10. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Masayuki Kobayashi & Akifumi Takaori-Kondo

  11. Department of Internal Medicine, Japan Community Health Care Organization Kobe Central Hospital, Kobe, Japan

    Yoko Adachi

  12. Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan

    Kensuke Ohta

  13. First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan

    Kazuyoshi Ishii & Shosaku Nomura

  14. Department of Hematology, PL General Hospital, Tondabayashi, Japan

    Mitsuhiro Matsuda

  15. Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kyoto, Japan

    Eiji Nakatani

Authors
  1. Tsutomu Kobayashi
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  2. Junya Kuroda
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  3. Shin-ichi Fuchida
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  4. Hitomi Kaneko
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  7. Hirokazu Tanaka
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  9. Nobuhiko Uoshima
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  10. Masayuki Kobayashi
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  12. Kensuke Ohta
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  13. Kazuyoshi Ishii
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  14. Hitoji Uchiyama
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  15. Mitsuhiro Matsuda
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  16. Eiji Nakatani
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  17. Mitsuru Tsudo
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  18. Chihiro Shimazaki
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  19. Akifumi Takaori-Kondo
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  20. Shosaku Nomura
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  21. Itaru Matsumura
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  22. Masafumi Taniwaki
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  23. Yuzuru Kanakura
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Correspondence to Tsutomu Kobayashi.

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Kobayashi, T., Kuroda, J., Fuchida, Si. et al. Impact of early use of lenalidomide and low-dose dexamethasone on clinical outcomes in patients with relapsed/refractory multiple myeloma. Int J Hematol 101, 37–45 (2015). https://doi.org/10.1007/s12185-014-1696-6

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  • DOI: https://doi.org/10.1007/s12185-014-1696-6

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