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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 (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 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 Citing Articles via Google Scholar Google Scholar Articles by Kapoor, P. Articles by Rajkumar, S. V. Search for Related Content PubMed PubMed Citation Articles by Kapoor, P. Articles by Rajkumar, S. V. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted January 28, 2009 Accepted March 13, 2009 Impact of risk stratification on outcome among patients with multiple myeloma receiving initial therapy with lenalidomide and dexamethasone Prashant Kapoor, Shaji Kumar, Rafael Fonseca, Martha Q. Lacy, Thomas E. Witzig, Suzanne R. Hayman, Angela Dispenzieri, Francis Buadi, P. Leif Bergsagel, Morie A. Gertz, Robert J. Dalton, Joseph R. Mikhael, David Dingli, Craig B. Reeder, John A. Lust, Stephen J. Russell, Vivek Roy, Steven R. Zeldenrust, A. Keith Stewart, Robert A. Kyle, Philip R. Greipp, and S. Vincent Rajkumar* Department of Internal Medicine, Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, United States Division of Hematology/Oncology, Mayo Clinic College of Medicine, Scottsdale, AZ, United States Division of Medical Oncology, Mayo Health System, Mankato, MN, United States Division of Hematology/Oncology, Mayo Clinic College of Medicine, Jacksonville, FL, United States * Corresponding author; email: rajks{at}mayo.edu. The outcome of patients with multiple myeloma (MM) is dictated primarily by cytogenetic abnormalities and proliferative capacity of plasma cells. We studied the outcome following initial therapy with lenalidomide-dexamethasone among 100 newly diagnosed patients, risk-stratified by genetic abnormalities and labeling index (PCLI). 16% had high-risk MM, defined by presence of hypodiploidy, del(13q) by metaphase cytogenetics, del(17p), IgH translocations [t(4;14) or t(14;16)] or PCLI3%. Response rates were 81% versus 89% in the high-risk and standard-risk groups, respectively. The median progression-free survival was shorter in the high-risk group; 18.5 versus 36.5 months (P<0.001), but overall survival was comparable. Due to 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 to 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. K. Kumar, J. R. Mikhael, F. K. Buadi, D. Dingli, A. Dispenzieri, R. Fonseca, M. A. Gertz, P. R. Greipp, S. R. Hayman, R. A. Kyle, et al. Management of Newly Diagnosed Symptomatic Multiple Myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines Mayo Clin. Proc., December 1, 2009; 84(12): 1095 - 1110. [Abstract] [Full Text] [PDF] S. Lonial Risky business in myeloma Blood, July 16, 2009; 114(3): 496 - 497. [Full Text] [PDF]

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