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International Journal of Hematology

, Volume 101, Issue 1, pp 37–45 | Cite as

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

  • Tsutomu KobayashiEmail author
  • Junya Kuroda
  • Shin-ichi Fuchida
  • Hitomi Kaneko
  • Hideo Yagi
  • Hirohiko Shibayama
  • Hirokazu Tanaka
  • Satoru Kosugi
  • Nobuhiko Uoshima
  • Masayuki Kobayashi
  • Yoko Adachi
  • Kensuke Ohta
  • Kazuyoshi Ishii
  • Hitoji Uchiyama
  • Mitsuhiro Matsuda
  • Eiji Nakatani
  • Mitsuru Tsudo
  • Chihiro Shimazaki
  • Akifumi Takaori-Kondo
  • Shosaku Nomura
  • Itaru Matsumura
  • Masafumi Taniwaki
  • Yuzuru Kanakura
  • KMF investigators
Original Article

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.

Keywords

Lenalidomide Multiple myeloma Relapse Refractory 

Notes

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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Copyright information

© The Japanese Society of Hematology 2014

Authors and Affiliations

  • Tsutomu Kobayashi
    • 1
    Email author
  • Junya Kuroda
    • 1
  • Shin-ichi Fuchida
    • 2
  • Hitomi Kaneko
    • 3
  • Hideo Yagi
    • 4
  • Hirohiko Shibayama
    • 5
  • Hirokazu Tanaka
    • 6
  • Satoru Kosugi
    • 7
  • Nobuhiko Uoshima
    • 8
    • 9
  • Masayuki Kobayashi
    • 10
  • Yoko Adachi
    • 11
  • Kensuke Ohta
    • 12
  • Kazuyoshi Ishii
    • 13
  • Hitoji Uchiyama
    • 8
  • Mitsuhiro Matsuda
    • 14
  • Eiji Nakatani
    • 15
  • Mitsuru Tsudo
    • 3
  • Chihiro Shimazaki
    • 2
  • Akifumi Takaori-Kondo
    • 10
  • Shosaku Nomura
    • 13
  • Itaru Matsumura
    • 6
  • Masafumi Taniwaki
    • 1
  • Yuzuru Kanakura
    • 5
  • KMF investigators
  1. 1.Division of Hematology and OncologyGraduate School of Medicine, Kyoto Prefectural University of MedicineKyotoJapan
  2. 2.Department of HematologyJapan Community Health Care Organization Kyoto-Kuramaguchi Medical CenterKyotoJapan
  3. 3.Department of HematologyOsaka Red Cross HospitalOsakaJapan
  4. 4.Department of HematologyNara Hospital Kinki University Faculty of MedicineNaraJapan
  5. 5.Department of Hematology and OncologyOsaka University Graduate School of MedicineOsakaJapan
  6. 6.Division of Hematology and Rheumatology, Department of Internal Medicine, Faculty of MedicineKinki UniversityHigashiosakaJapan
  7. 7.Department of HematologyToyonaka Municipal HospitalToyonakaJapan
  8. 8.Department of HematologyJapanese Red Cross Kyoto Daini HospitalKyotoJapan
  9. 9.Department of HematologyMatsushita Memorial HospitalMoriguchiJapan
  10. 10.Department of Hematology and OncologyGraduate School of Medicine, Kyoto UniversityKyotoJapan
  11. 11.Department of Internal MedicineJapan Community Health Care Organization Kobe Central HospitalKobeJapan
  12. 12.Department of HematologyOsaka Saiseikai Nakatsu HospitalOsakaJapan
  13. 13.First Department of Internal MedicineKansai Medical UniversityHirakataJapan
  14. 14.Department of HematologyPL General HospitalTondabayashiJapan
  15. 15.Translational Research Informatics Center, Foundation for Biomedical Research and InnovationKyotoJapan

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