title: Long-term outcome with lenalidomide and dexamethasone therapy for newly diagnosed multiple myeloma.
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.
authors: Division of Hematology and Blood and Marrow Transplant, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors: G
authors: G
authors: Srivastava
authors: V
authors: V
authors: Rana
authors: M Q
authors: MQ
authors: Lacy
authors: F K
authors: FK
authors: Buadi
authors: S R
authors: SR
authors: Hayman
authors: A
authors: A
authors: Dispenzieri
authors: M A
authors: MA
authors: Gertz
authors: D
authors: D
authors: Dingli
authors: S
authors: S
authors: Zeldenrust
authors: S
authors: S
authors: Russell
authors: A
authors: A
authors: McCurdy
authors: P
authors: P
authors: Kapoor
authors: R
authors: R
authors: Kyle
authors: S V
authors: SV
authors: Rajkumar
authors: S
authors: S
authors: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide
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