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Blood, 16 July 2009, Vol. 114, No. 3, pp. 518-521. Prepublished online as a Blood First Edition Paper on March 26, 2009; DOI 10.1182/blood-2009-01-202010. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2009-01-202010v1 114/3/518    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Kapoor, P. Articles by Rajkumar, S. V. PubMed PubMed Citation Articles by Kapoor, P. Articles by Rajkumar, S. V. Related Collections Lymphoid Neoplasia Brief Reports Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Brief Report Impact of risk stratification on outcome among patients with multiple myeloma receiving initial therapy with lenalidomide and dexamethasone Prashant Kapoor1, Shaji Kumar1, Rafael Fonseca2, Martha Q. Lacy1, Thomas E. Witzig1, Suzanne R. Hayman1, Angela Dispenzieri1, Francis Buadi1, P. Leif Bergsagel2, Morie A. Gertz1, Robert J. Dalton3, Joseph R. Mikhael2, David Dingli1, Craig B. Reeder2, John A. Lust1, Stephen J. Russell1, Vivek Roy4, Steven R. Zeldenrust1, A. Keith Stewart2, Robert A. Kyle1, Philip R. Greipp1, and S. Vincent Rajkumar1 1 Department of Internal Medicine, Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN; 2 Division of Hematology/Oncology, Mayo Clinic College of Medicine, Scottsdale, AZ; 3 Division of Medical Oncology, Mayo Health System, Mankato, MN; and 4 Division of Hematology/Oncology, Mayo Clinic College of Medicine, Jacksonville, FL The outcome of patients with multiple myeloma is dictated primarily by cytogenetic abnormalities and proliferative capacity of plasma cells. We studied the outcome after initial therapy with lenalidomide-dexamethasone among 100 newly diagnosed patients, risk-stratified by genetic abnormalities and plasma cell labeling index. A total of 16% had high-risk multiple myeloma, defined by the presence of hypodiploidy, del(13q) by metaphase cytogenetics, del(17p), IgH translocations [t(4;14), or t(14;16)] or plasma cell labeling index more than or equal to 3%. Response rates were 81% vs 89% in the high-risk and standard-risk groups, respectively. The median progression-free survival was shorter in the high-risk group (18.5 vs 36.5 months, P < .001), but overall survival was comparable. Because of unavailability of all tests for every patient, we separately analyzed 55 stringently classified patients, and the results were similar. In conclusion, high-risk patients achieve less durable responses with lenalidomide-dexamethasone compared with standard-risk patients; no significant differences in overall survival are apparent so far. These results need confirmation in larger, prospectively designed studies. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Risky business in myeloma Sagar Lonial Blood 2009 114: 496-497. [Full Text] [PDF] This article has been cited by other articles: S. Lonial Risky business in myeloma Blood, July 16, 2009; 114(3): 496 - 497. [Full Text] [PDF]

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