A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
RVD induction and autologous stem cell transplantation followed by lenalidomide maintenance in newly diagnosed multiple myeloma: a phase 2 study of the Finnish Myeloma Group
Tekijät: Sini Luoma, Pekka Anttila, Marjaana Säily, Tuija Lundan, Jouni Heiskanen, Timo Siitonen, Sakari Kakko, Mervi Putkonen, Hanna Ollikainen, Venla Terävä, Marja Sankelo, Anu Partanen, Kirsi Launonen, Anu Räsänen, Anu Sikiö, Merja Suominen, Piotr Bazia, Kristiina Kananen, Juha Lievonen, Tuomas Selander, Tarja-Terttu Pelliniemi, Sorella Ilveskero, Virva Huotari, Pentti Mäntymaa, Anri Tienhaara, Esa Jantunen, Raija Silvennoinen
Kustantaja: SPRINGER
Julkaisuvuosi: 2019
Journal: Annals of Hematology
Tietokannassa oleva lehden nimi: ANNALS OF HEMATOLOGY
Lehden akronyymi: ANN HEMATOL
Vuosikerta: 98
Numero: 12
Aloitussivu: 2781
Lopetussivu: 2792
Sivujen määrä: 12
ISSN: 0939-5555
eISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-019-03815-7
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/45159108
Autologous stem cell transplantation (ASCT) combined with novel agents is the standard treatment for transplant-eligible, newly diagnosed myeloma (NDMM) patients. Lenalidomide is approved for maintenance after ASCT until progression, although the optimal duration of maintenance is unknown. In this trial, 80 patients with NDMM received three cycles of lenalidomide, bortezomib, and dexamethasone followed by ASCT and lenalidomide maintenance until progression or toxicity. The primary endpoint was the proportion of flow-negative patients. Molecular response was assessed if patients were flow-negative or in stringent complete response (sCR). By intention to treat, the overall response rate was 89%. Neither median progression-free survival nor overall survival (OS) has been reached. The OS at 3 years was 83%. Flow-negativity was reached in 53% and PCR-negativity in 28% of the patients. With a median follow-up of 27 months, 29 (36%) patients are still on lenalidomide and 66% of them have sustained flow-negativity. Lenalidomide maintenance phase was reached in 8/16 high-risk patients but seven of them have progressed after a median of only 6 months. In low- or standard-risk patients, the outcome was promising, but high-risk patients need more effective treatment approach. Flow-negativity with the conventional flow was an independent predictor for longer PFS.
Ladattava julkaisu This is an electronic reprint of the original article. |  |
