Nationwide implementation of lenalidomide maintenance in multiple myeloma: A retrospective, real-world study.

Autor: Harsløf M; Department of Hematology Rigshospitalet Copenhagen Denmark.; Biotech Research and Innovation Centre University of Copenhagen Kobenhavn Denmark., Chanchiri I; Department of Hematology Odense University Hospital Odense Denmark., Silkjær T; Department of Hematology Aarhus University Hospital Aarhus Denmark., Frølund UC; Department of Hematology Zealand University Hospital Roskilde Denmark., Teodorescu EM; Department of Hematology Aalborg University Hospital Aalborg Denmark., Nielsen KB; Department of Hematology Regionshospitalet Gødstrup Herning Denmark., Nielsen PI; Department of Hematology Esbjerg Hospital Esbjerg Denmark., Pedersen PT; Department of Hematology Esbjerg Hospital Esbjerg Denmark., Iversen KF; Department of Hematology Vejle Hospital Vejle Denmark., Lund T; Department of Hematology Odense University Hospital Odense Denmark., Grønbæk K; Department of Hematology Rigshospitalet Copenhagen Denmark.; Biotech Research and Innovation Centre University of Copenhagen Kobenhavn Denmark., Thorsteinsdottir S; Department of Hematology Rigshospitalet Copenhagen Denmark., Vangsted A; Department of Hematology Rigshospitalet Copenhagen Denmark., Szabo AG; Department of Hematology Rigshospitalet Copenhagen Denmark.; Department of Hematology Vejle Hospital Vejle Denmark.
Jazyk: angličtina
Zdroj: EJHaem [EJHaem] 2024 Mar 27; Vol. 5 (2), pp. 316-324. Date of Electronic Publication: 2024 Mar 27 (Print Publication: 2024).
DOI: 10.1002/jha2.881
Abstrakt: Lenalidomide maintenance (LM) has shown benefit in progression-free survival (PFS) and overall survival (OS) in clinical trials. LM is the recommended standard of care in patients with newly diagnosed multiple myeloma (MM) after high-dose melphalan and autologous stem cell transplantation (HDM-ASCT). In Denmark, LM has been approved and publicly funded for all patients treated with HDM-ASCT since June 2019. Patients with newly diagnosed MM treated with their first HDM-ASCT between June 2019 and March 2022 were included and followed until data cut-off in June 2023. To compare outcomes, a historical pre-LM cohort from the Danish MM Registry, consisting of 364 MM patients treated with HDM-ASCT between June 2015 and June 2019, was used. Among 364 patients treated with HDM-ASCT after June 2019, 22.3% received consolidation therapy and 3.7% underwent tandem HDM-ASCT. During follow-up, 297 patients (81.6%) initiated maintenance therapy, with 277 (76.1%) receiving LM. Overall, 145 patients (52.3%) discontinued LM most commonly due to toxicity 75 (51.7%), with fatigue (30.7%), cytopenia (25.3%), and neuropathy (17.3%) being the main reasons. In a 6-month landmark analysis, early discontinuation did not negatively impact PFS or OS. The LM cohort had similar PFS, and OS compared to the pre-LM cohort. The 3-year PFS and OS rates in the LM cohort were 61% and 86%, respectively, while the pre-LM cohort had a 3-year PFS of 55% and a 3-year OS of 89%. In conclusion, the introduction of LM as a nationwide treatment option in Denmark did not lead to improved clinical outcomes.
Competing Interests: All authors declare they have no conflicts of interest
(© 2024 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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