International Journal of Hematology

DOI: 10.1007/s12185-018-2543-y Pages: 1-8

A phase II study of lenalidomide consolidation and maintenance therapy after autologous PBSCT in patients with multiple myeloma

1. Japan Community Health care Organization Kyoto Kuramaguchi Medical Center, Department of Hematology

2. National Hospital Organization Okayama Medical Center

3. National Hospital Organization Nishigunma National Hospital

4. Toyama Prefectural Central Hospital

5. Hyogo Cancer Center

6. Kyushu University Hospital

7. Oita Prefectural Hospital

8. Akita University Hospital

9. Tochigi Cancer Center

10. Ise Red Cross Hospital

11. Japanese Red Cross Society Himeji Hospital

12. Hiroshima University Hospital

13. Karatsu Higashimatsuura Medical Association

Correspondence to:
Shin-ichi Fuchida
Tel: +81-75-441-6101
Email: sfuch0614@gaia.eonet.ne.jp

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Abstract

The efficacy and safety of lenalidomide (LEN) consolidation therapy and subsequent LEN maintenance therapy after high-dose therapy with autologous peripheral blood stem cell transplantation (auto-PBSCT) were evaluated in patients with newly diagnosed symptomatic multiple myeloma (MM). Forty-one patients were enrolled and received high-dose dexamethasone (DEX) therapy as an initial induction. The patients who did not respond to the DEX therapy were further treated with four cycles of bortezomib plus DEX (BD) induction therapy. For patients who responded to BD, PBSC harvesting was scheduled following high-dose cyclophosphamide and filgrastim administration. After PBSC harvesting, high-dose chemotherapy of melphalan with auto-PBSCT was performed. One hundred days after auto-PBSCT, patients received consolidation therapy consisting two cycles of LEN plus low-dose DEX (Ld) and LEN maintenance therapy. Only one death occurred during mobilization therapy, but the protocol developed in this study was considered generally safe to provide. Overall response rates after consolidation and maintenance therapies were 73.7% and 81.6%, respectively. Two-year progression-free survival and overall survival were 76.3% and 92.1%, respectively. These observations suggest that LEN consolidation and maintenance therapy are effective and safe, and provide favorable response rates in patients with MM.

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