Is Induction With Lenalidomide-Based Therapy Plus Tandem ASCT of Benefit in Multihit Myeloma?
Posted: Monday, December 6, 2021
Pei et al, of the Affiliated People’s Hospital of Ningbo University, China, conducted a study to investigate the efficacy of induction chemotherapy with lenalidomide, bortezomib, and dexamethasone (VRD) followed by tandem autologous stem cell transplantation (ASCT) in patients with multihit multiple myeloma. This retrospective data analysis, which was published in the journal Leukemia Research, also explored the prognostic factors of multiple myeloma.
“[Induction therapy with VRD] has an advantage in improving the overall response rate of multihit multiple myeloma, [whereas] a single ASCT has limited effect on improving the 2-year progression-free survival and overall survival of multihit multiple myeloma,” the investigators commented. “Compared with single ASCT, tandem ASCT can significantly improve the prognosis of multihit multiple myeloma.”
The investigators focused on 252 patients with newly diagnosed multiple myeloma who were treated with a bortezomib-containing induction regimen. Based on the results of fluorescence in situ hybridization at diagnosis, they were divided into multihit (n = 47), single-hit (n = 81), and standard-risk (n = 124) groups.
In patients who underwent ASCT, revised International Staging System (R-ISS) stage III disease seemed to be an independent factor for poor prognosis. R-ISS stage III disease, multihit status, and inability to achieve a very good partial response or better at the fourth cycle of chemotherapy appeared to be independent factors for poor prognosis in those who did not undergo ASCT.
Compared with other regimens, the overall response rate seemed to be significantly higher with VRD in the single-hit (P = .021) and multihit (P = .032) groups. Tandem ASCT appeared to significantly improve the 2-year progression-free (77.8 %; P = .024) and overall (83.3%; P = .037) survival rates in patients with multihit multiple myeloma; the investigators noted that single ASCT had a limited effect on progression-free (61.5%; P = .115) and overall (71.9%; P = .155) survival.
Disclosure: The study authors reported no conflicts of interest.
