Low-dose lenalidomide and dexamethasone therapy after melphalan-prednisolone induction in elderly patients with newly diagnosed multiple myeloma

Annals of Hematology - Tập 99 - Trang 2351-2356 - 2020
Yasushi Onishi1, Hisayuki Yokoyama1,2, Yuna Katsuoka2, Toshihiro Ito2, Tomohumi Kimura3, Joji Yamamoto4, Shinji Nakajima5, Osamu Sasaki6, Takahide Ara7, Koichiro Minauchi7, Osamu Fukuhara8, Naoki Kobayashi7, Hideyoshi Noji9, Shuichi Ota, Hideo Harigae1
1Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
2Department of Hematology, Sendai Medical Center, National Hospital Organization, Sendai, Japan
3Department of Hematology, Suihu Hospital, Ibaraki, Japan
4Department of Hematology, Sendai City Hospital, Sendai, Japan
5Department of Hematology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
6Department of Hematology, Miyagi Cancer Center, Natori, Japan
7Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
8Department of Hematology, Japanese Red Cross Sendai Hospital, Sendai, Japan
9Department of Hematology, Fukushima Medical University, Fukushima, Japan

Tóm tắt

Lenalidomide (Len) and dexamethasone (dex) therapy is a standard therapy in patients with multiple myeloma. Elderly or unfit patients may reduce Len or dex doses to prevent toxicities that lead to treatment discontinuation. However, there have been few studies evaluating the efficacy and safety of lower doses of Len and dex. We conducted a phase II study of 1.5-year low-dose Len and dex therapy following melphalan and prednisolone (MP), the number of which cycles was determined by a response within 9 cycles. The Len dose was 10 mg daily and the dex dose was 20 mg weekly, which were continued for 1.5 years. Twenty-one patients were enrolled. The median number of cycles of MP was 3 (range, 2–9). The overall response rate was 81% and a very good partial response or better was achieved in 33.3% of patients. The median follow-up time for survivors was 70.5 months (range, 42–83 months), the median progression-free survival (PFS) was 27 months (95% CI, 21–33 months), and the median overall survival was not reached. Grade 3 or 4 adverse events were observed in 28.6% of patients. In conclusion, the low-dose Len and dex therapy safely achieved comparable efficacies to the standard-dose regimen in elderly patients with newly diagnosed multiple myeloma. UMIN000007889.

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