TY - JOUR
T1 - Melphalan, prednisone, and lenalidomide for newly diagnosed myeloma
T2 - Kinetics of neutropenia and thrombocytopenia and time-to-event results
AU - Palumbo, Antonio
AU - Falco, Patrizia
AU - Falcone, Antonietta
AU - Benevolo, Giulia
AU - Canepa, Letizia
AU - Gay, Francesca
AU - Larocca, Alessandra
AU - Magarotto, Valeria
AU - Gozzetti, Alessandro
AU - Luraschi, Annalisa
AU - Morabito, Fortunato
AU - Nozza, Andrea
AU - Knight, Robert
AU - Zeldis, Jerome
AU - Boccadoro, Mario
AU - Petrucci, Maria Teresa
PY - 2009
Y1 - 2009
N2 - Background: Initial analysis of the combination melphalan, prednisone, plus lenalidomide (MPR) showed significant antimyeloma activity in patients with untreated multiple myeloma, with neutropenia and thrombocytopenia as the most frequent side effects. This updated analysis reassessed the kinetics of neutropenia and thrombocytopenia as well as the safety and efficacy of MPR. Patients and Methods: A total of 21 patients with newly diagnosed myeloma received melphalan 0.18 mg/kg on days 1-4, prednisone 2 mg/kg on days 1-4, and lenalidomide 10 mg daily on days 1-21 for nine 28-day cycles, followed by maintenance therapy with lenalidomide 10 mg daily on days 1-21. Results: Grade 3/4 neutropenia occurred in 52% of the patients, and granulocyte colonystimulating factor was administered in 43%. The mean neutrophil counts at the start of each MPR cycle, during nadir, and after 6 months of maintenance were 2.69 × 109/L, 1.43 × 109/L, and 2.11 × 109/L, respectively. Grade 3/4 thrombocytopenia occurred in 24% of the patients. Platelet transfusions were required by 1 patient (5%) with a platelet count of 16 × 109/L; however, no thrombocytopenia-associated bleeding was reported. The mean platelet counts at the start of each cycle, during nadir, and after 6 months of maintenance were 174 × 109/L, 121 × 109/L, and 158 × 109/L, respectively. Median follow-up was 29.6 months, median progression-free survival was 28.5 months, and 2-year overall survival was 91%. Conclusion: MPR is a promising regimen with manageable hematologic toxicity.
AB - Background: Initial analysis of the combination melphalan, prednisone, plus lenalidomide (MPR) showed significant antimyeloma activity in patients with untreated multiple myeloma, with neutropenia and thrombocytopenia as the most frequent side effects. This updated analysis reassessed the kinetics of neutropenia and thrombocytopenia as well as the safety and efficacy of MPR. Patients and Methods: A total of 21 patients with newly diagnosed myeloma received melphalan 0.18 mg/kg on days 1-4, prednisone 2 mg/kg on days 1-4, and lenalidomide 10 mg daily on days 1-21 for nine 28-day cycles, followed by maintenance therapy with lenalidomide 10 mg daily on days 1-21. Results: Grade 3/4 neutropenia occurred in 52% of the patients, and granulocyte colonystimulating factor was administered in 43%. The mean neutrophil counts at the start of each MPR cycle, during nadir, and after 6 months of maintenance were 2.69 × 109/L, 1.43 × 109/L, and 2.11 × 109/L, respectively. Grade 3/4 thrombocytopenia occurred in 24% of the patients. Platelet transfusions were required by 1 patient (5%) with a platelet count of 16 × 109/L; however, no thrombocytopenia-associated bleeding was reported. The mean platelet counts at the start of each cycle, during nadir, and after 6 months of maintenance were 174 × 109/L, 121 × 109/L, and 158 × 109/L, respectively. Median follow-up was 29.6 months, median progression-free survival was 28.5 months, and 2-year overall survival was 91%. Conclusion: MPR is a promising regimen with manageable hematologic toxicity.
KW - Elderly patients
KW - Granulocyte colony-stimulating factor
KW - Myelotoxicity
KW - Neutropenia
KW - Thrombocytopenia
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U2 - 10.3816/CLM.2009.n.035
DO - 10.3816/CLM.2009.n.035
M3 - Article
C2 - 19406725
AN - SCOPUS:67650657867
VL - 9
SP - 145
EP - 150
JO - Clinical Lymphoma and Myeloma
JF - Clinical Lymphoma and Myeloma
SN - 1557-9190
IS - 2
ER -