Multiple Myeloma Coverage from Every Angle

Chemotherapy for Newly Diagnosed Myeloma in Low-Income Setting: Long-Term Findings

By: Kayci Reyer
Posted: Tuesday, October 12, 2021

According to research presented in JCO Global Oncology, a chemotherapy combination of cyclophosphamide, thalidomide, and dexamethasone may be an attainable approach to therapy for patients with multiple myeloma living in low-income countries. This treatment regimen appears to be the most effective for patients aged 65 or younger.

“These findings can be applied to low- and middle-income countries struggling to have access to novel treatments such as bortezomib, lenalidomide, and daratumumab,” noted Luis Casanova, MD, of Instituto Oncológico Miraflores in Lima, and colleagues. In addition, “this oral regimen can be used in patients who are both transplant-eligible and transplant-ineligible.”

The retrospective study included 59 patients with newly diagnosed multiple myeloma who were treated at the authors’ institution in Lima between April 2008 and December 2012. In 28-day cycles, patients received 400 mg/m2 of cyclophosphamide for 5 days; 100 mg of daily thalidomide, assuming tolerability; and 40 mg of once-weekly dexamethasone. The median number of treatment cycles patients completed was 11.

At a median follow-up of 81 months, the overall response, complete response, and very good partial response rates were 69.5%, 5%, and 32%, respectively. The median progression-free survival was 35 months. The 3-year progression-free survival was 47.4% versus 24.9% for the 5-year progression-free survival. The median overall survival was 81 months, with a 3-year rate of 63.4% and a 5-year rate of 57.5%.

Neutropenia was the most common adverse event reported with the chemotherapy regimen. A total of four treatment-related deaths were recorded. Autologous transplantation was administered to 10 patients, 43.5% of the 23 patients eligible for stem cell transplantation.

Disclosure: For full disclosures of the study authors, visit

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