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Impact of chromosomal abnormalities on the efficacy of lenalidomide plus dexamethasone treatment in patients with relapsed/refractory multiple myeloma

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Abstract

Lenalidomide is an effective therapeutic agent for multiple myeloma (MM). However, its efficacy in the context of chromosomal abnormalities (CA) is poorly understood. We retrospectively analyzed 83 patients with relapsed/refractory (RR) MM, who received lenalidomide plus low-dose dexamethasone (Ld), in the context of CA. The median age and number of prior therapies were 69 and 2, respectively. Three, 11, 45, and 19 patients achieved complete response, very good partial response, partial response, and stable disease, respectively. Median progression-free survival (PFS) and overall survival (OS) were 11.1 and 38.8 months, respectively. Seventy-two patients were evaluated for frequently observed translocations; median PFS was 24.4 months in 20 patients with t(11;14), 13.0 months in 16 patients with t(4;14), and 3.7 months in seven patients with t(14;16). G-banded karyotype analysis detected 11 hypodiploid patients, who had shorter PFS and OS (2.5 and 6.2 months, respectively) compared to others (13.0 and 43.7 months, respectively). Hypodiploid patients showed poor clinical outcome, whereas patients with t(11;14) showed favorable outcome. In summary, the present study presents the clinical impact of chromosomal abnormalities on the outcome of Ld therapy, and contributes to understanding the appropriate choice of lenalidomide-based therapy to achieve effective treatment of RR MM.

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Acknowledgements

This work was partly supported by a Grant-in-Aids for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (16K07179 & 16K09855), the National Cancer Center Research and Development Fund (26-A-4), and the Practical Research for Innovative Cancer Control from Japan Agency for Medical Research and development, AMED (15ck0106077h0002).

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Authors and Affiliations

  1. Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan

    Takashi Yoshida, Masaki Ri, Haruna Fujinami, Yoshiko Oshima, Takuto Tachita, Yoshiaki Marumo, Hirokazu Sasaki, Shiori Kinoshita, Haruhito Totani, Tomoko Narita, Ayako Masaki, Asahi Ito, Shigeru Kusumoto, Takashi Ishida, Hirokazu Komatsu & Shinsuke Iida

  2. Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, Aomori, 036-8216, Japan

    Takuto Tachita

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  1. Takashi Yoshida
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Correspondence to Masaki Ri.

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Conflict of interest

MR received research funding from Celgene Co., Ltd. SI received research funding and declares Honoraria from Janssen Pharmaceutical K.K., and Celgene Co., Ltd. SI also received research funding from Kyowa Hakko Kirin Co., Ltd., Chugai Pharmaceutical Co., Ltd., Bristol-Myers Squibb, Takeda Yakuhin Co., Ltd., and Ono Pharmaceutical Co., Ltd.

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Yoshida, T., Ri, M., Fujinami, H. et al. Impact of chromosomal abnormalities on the efficacy of lenalidomide plus dexamethasone treatment in patients with relapsed/refractory multiple myeloma. Int J Hematol 110, 228–236 (2019). https://doi.org/10.1007/s12185-019-02669-z

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