Early mortality in myeloma patients treated with first-generation novel agents thalidomide, lenalidomide, bortezomib at diagnosis: A pooled analysis

S. Bringhen, M. Offidani, S. Palmieri, F. Pisani, R. Rizzi, S. Spada, A. Evangelista, N. Di Renzo, P. Musto, M. Marcatti, R. Vallone, S. Storti, A. Bernardini, R. Centurioni, E. Aitini, A. Palmas, O. Annibali, E. Angelucci, P. Ferrando, A. BaraldiS. Rocco, A. Andriani, A. Siniscalchi, V. De Stefano, V. Meneghini, A. Palumbo, S. Grammatico, M. Boccadoro, A. Larocca

Research output: Contribution to journalArticlepeer-review


Introduction: Early toxic death (≤60 days of diagnosis) in elderly multiple myeloma (MM) patients is attributable to active disease, age and co-morbidities. Rate of early toxic deaths is 10% with conventional chemotherapy mainly due to infection and renal failure. Novel agents have improved MM outcome at the expense of newer toxicity. Methods: We analyzed 1146 individual patient data to assess toxic deaths during induction treatment with first-generation novel agents thalidomide, lenalidomide, bortezomib. Results: During first-line therapy, 119/1146 patients (10%) died for any cause, and 47/1146 (4%) due to toxicity, including 12/1146 (1%) early deaths. The 24-month cumulative incidence was 4.1% without any difference between bortezomib (18/503 patients, 4%) and lenalidomide (29/643patients, 5%; p = 0.31). Toxic deaths occurred in 34/1039 (3%) patients
Original languageEnglish
Pages (from-to)27-35
Number of pages9
JournalCritical Reviews in Oncology/Hematology
Publication statusPublished - 2018


  • acetylsalicylic acid
  • bortezomib
  • cotrimoxazole
  • cyclophosphamide
  • dexamethasone
  • lenalidomide
  • low molecular weight heparin
  • melphalan
  • prednisone
  • quinoline derived antiinfective agent
  • thalidomide
  • warfarin
  • antineoplastic agent
  • thalidomide, age
  • aged
  • antibiotic prophylaxis
  • bleeding
  • cancer staging
  • cause of death
  • cerebrovascular accident
  • controlled study
  • drug fatality
  • female
  • gastrointestinal disease
  • gastrointestinal infection
  • heart arrest
  • heart arrhythmia
  • heart disease
  • heart failure
  • human
  • incidence
  • induction chemotherapy
  • infection
  • kidney disease
  • low drug dose
  • lung disease
  • lung embolism
  • major clinical study
  • male
  • mortality
  • multiple cycle treatment
  • multiple myeloma
  • pneumonia
  • Review
  • risk factor
  • second cancer
  • sepsis
  • sudden death
  • vascular disease
  • analogs and derivatives
  • meta analysis
  • survival rate
  • treatment outcome, Antineoplastic Combined Chemotherapy Protocols
  • Bortezomib
  • Humans
  • Multiple Myeloma
  • Survival Rate
  • Thalidomide
  • Treatment Outcome


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