Department of Oncology, Hematology, Immunology, Rheumatology and Pulmonology, University Hospital of Tuebingen, Tubingen, Germany.
Ann Hematol. 2014 Dec;93(12):1993-9. doi: 10.1007/s00277-014-2149-2. Epub 2014 Jul 1.
Lenalidomide in combination with dexamethasone is an effective and well-established treatment of relapsed or refractory multiple myeloma (rrMM) disease. Due to the scarcity of reports assessing benefit and risk of long-term lenalidomide treatment in non-selected rrMM patients, we retrospectively analysed the long-term outcome in patients with rrMM treated with lenalidomide and dexamethasone. Sixty-seven patients (pts) who were treated with lenalidomide/dexamethasone for rrMM in the approved indication from 2007 to 2011 were included in this retrospective, single-centre analysis. Kaplan-Meier survival estimates were compared between total population, patients on lenalidomide for more than 12 months (mo) and patients discontinuing therapy earlier than 12 months. Median overall survival (OS) of the total patient population was 33.2 mo. OS of pts treated beyond 12 mo was 42.9 mo compared to 20.2 mo (p = 0.027) for pts stopping lenalidomide earlier than 12 mo for other reasons than progression disease (PD). OS of pts >12 mo on lenalidomide treatment did not significantly differ between pts who had received previous autologous transplantation, allogeneic transplantation or conventional therapy. Main non-hematologic toxicities were infections of grade 3/4 in 25 % and thrombembolic events of all grades in 18 % of patients. To the best of our knowledge, this is the first report on feasibility and efficacy of long-term lenalidomide treatment in a non-selected patient cohort. OS of pts >12 mo on lenalidomide is superior when compared to pts discontinued earlier for reasons other than PD. Our data confirm the current use of lenalidomide as a continuous long-term treatment strategy.
来那度胺联合地塞米松是一种有效的、成熟的复发性或难治性多发性骨髓瘤（rrMM）疾病的治疗方法。由于缺乏评估非选择性 rrMM 患者长期来那度胺治疗获益和风险的报告，我们回顾性分析了接受来那度胺和地塞米松治疗的 rrMM 患者的长期结局。在批准的适应证下，我们从 2007 年至 2011 年对 67 例（pts）rrMM 患者进行了来那度胺/地塞米松治疗，将其纳入了这项回顾性单中心分析。总人群、接受来那度胺治疗超过 12 个月（mo）的患者和在 12 个月前停药的患者之间的总生存期（OS）用 Kaplan-Meier 生存估计进行比较。总患者人群的中位 OS 为 33.2 mo。在 12 个月前因其他原因（而非疾病进展[PD]）停止来那度胺治疗的 pts 中，治疗时间超过 12 个月的 OS 为 42.9 mo，而 OS 为 20.2 mo（p = 0.027）。在 12 个月前接受来那度胺治疗的 pts 中，先前接受过自体移植、异基因移植或常规治疗的 OS 没有显著差异。主要的非血液学毒性是 25%的 3/4 级感染和 18%的所有等级的血栓栓塞事件。据我们所知，这是第一项关于非选择性患者队列中接受来那度胺长期治疗的可行性和疗效的报告。与因 PD 以外的其他原因提前停药的 pts 相比，接受来那度胺治疗超过 12 个月的 pts 的 OS 更高。我们的数据证实了目前将来那度胺用作连续长期治疗策略的应用。
