title: Impact of disease status on outcome in relapsed and refractory multiple myeloma treated with lenalidomide.
abstract: The introduction of immunomodulatory drugs such as lenalidomide combined with dexamethasone (Len/Dex) has improved the outcome of patients with relapsed/refractory multiple myeloma (RRMM). Few data are currently available which investigate whether paraprotein relapse represents an indication for starting a new treatment. The aim of our retrospective, single-center study was to analyze the impact of disease status (relapsed/refractory) and type of relapse (clinical/paraprotein) on response rate and time-to-next-treatment (TNT). We included 74 patients (median age 70 years) with RRMM treated with Len/Dex until progression or unacceptable toxicity from 2008 to 2012. Age and disease status were not factors affecting overall response rate (ORR) and median TNT, but TNT was significantly longer in patients with asymptomatic compared to clinical relapse (34 vs. 19 months, p<0.008). In conclusion, Len/Dex represents an effective treatment with satisfactory ORR and outcomes in RRMM, especially for patients starting therapy in asymptomatic relapse.
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Nozzoli
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Staderini
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Veltroni
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Longo
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bacchiarri
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Donnini
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Agata
authors.initials: A
authors.lastname: Guarrera
authors.affiliation: a Hematology Department, Azienda Ospedaliero Universitaria Careggi , Firenze , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D012008:Recurrence; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Myeloma; pharmacotherapeutics; prognostication