title: Cytogenetic Impact on Lenalidomide Treatment in Relapsed/Refractory Multiple Myeloma: A Real-Life Evaluation.
abstract: BACKGROUND
  In this retrospective real-life study in relapsed/refractory multiple myeloma patients, we analyzed clinical and biologic features distinguishing patients with rapidly progressing disease while receiving lenalidomide therapy from those without progression.
  
  
  METHODS
  According to time of stopping lenalidomide, patients were subdivided into 3 groups: early stop (ES) (n = 23), when therapy was discontinued within 6 months; intermediate (INT) (n = 23), when therapy was stopped between 7 to 24 months; and long survival (LS) (n = 45), when therapy was maintained for more than 2 years. The median age of the whole cohort was 70 years (range, 42-85 years); 40% had an International Staging System score of 2 or 3.
  
  
  RESULTS
  High-risk cytogenetic findings, including 1q gain, was reported in 65% ES, 43% INT, and 21% LS. Overall response rate was 63%, with median progression-free survival and overall survival of 33 and 56 months, respectively.
  
  
  CONCLUSIONS
  Although high-risk cytogenetic findings negatively affect progression-free survival and overall survival, 28% of cytogenetic high-risk patients experienced long survival, provided that lenalidomide therapy was not discontinued, thus pointing to the role of maintenance therapy in this subset of patients.
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy. Electronic address: r.zambello@unipd.it.
authors.forename: Renato
authors.initials: R
authors.lastname: Zambello
authors.affiliation: Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bonaldi
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Tamara
authors.initials: T
authors.lastname: Berno
authors.affiliation: Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Martines
authors.affiliation: Department of Pharmaceutical and Pharmacological Sciences, Padova University Hospital, Padova, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Sechettin
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: De March
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Branca
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Albana
authors.initials: A
authors.lastname: Lico
authors.affiliation: Division of Oncology, Mirano, Venice, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Minotto
authors.affiliation: Department of Neurosciences, Padova University, Padova, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Gurrieri
authors.affiliation: Department of Pharmaceutical and Pharmacological Sciences, Padova University Hospital, Padova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Temporin
authors.affiliation: Department of Pharmaceutical and Pharmacological Sciences, Padova University Hospital, Padova, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Battistutta
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Piazza
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Cavraro
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Trentin
authors.affiliation: Department of Medicine, Hematology and Clinical Immunology Branch, Padova University, Padova, Italy.
authors.forename: Gianpietro
authors.initials: G
authors.lastname: Semenzato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002871:Chromosome Banding; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide
keywords: Continous treatment; Cytogenetic; Lenalidomide; Real life evaluation; Refractory-relapsed multiple myeloma