Blood Journal
Leading the way in experimental and clinical research in hematology

Brief Report
Influence of cytogenetics in patients with relapsed or refractory multiple myeloma treated with lenalidomide plus dexamethasone: adverse effect of deletion 17p13

  1. Donna Reece1,
  2. Kevin W. Song2,
  3. Tommy Fu3,
  4. Birgitte Roland4,
  5. Hong Chang1,
  6. Douglas E. Horsman5,
  7. Adnan Mansoor6,
  8. Christine Chen1,
  9. Esther Masih-Khan1,
  10. Young Trieu1,
  11. Helene Bruyere7,
  12. Douglas A. Stewart8, and
  13. Nizar J. Bahlis8
  1. 1Division of Oncology, Princess Margaret Hospital, Toronto, ON;
  2. 2Division of Hematology, Vancouver General Hospital, Vancouver, BC;
  3. 3Celgene Corporation, Summit, NJ;
  4. 4Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB;
  5. 5Department of Pathology and Laboratory Medicine, British Columbia Cancer Agency, Vancouver, BC;
  6. 6Division of Hematology and Transfusion Medicine, Calgary Laboratory Services, Calgary, AB;
  7. 7Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, BC; and
  8. 8Division of Hematology and Bone Marrow Transplant, University of Calgary, Calgary, AB

Abstract

Although the combination of lenalidomide and dexamethasone is effective therapy for patients with relapsed/refractory multiple myeloma, the influence of high-risk cytogenetic abnormalities on outcomes is unknown. This subanalysis of a large, open-label study investigated the effects of the most common unfavorable cytogenetic abnormalities detected by fluorescence in situ hybridization, del(13q), t(4;14), and del(17p13), in 130 evaluable patients treated with this regimen. Whereas patients with either del(13q) or t(4;14) experienced a median time to progression and overall survival comparable with those without these cytogenetic abnormalities, patients with del(17p13) had a significantly worse outcome, with a median time to progression of 2.22 months (hazard ratio, 2.82; P < .001) and median overall survival of 4.67 months (hazard ratio, 3.23; P < .001). Improved therapeutic strategies are required for this subgroup of patients. This study was registered at www.ClinicalTrials.gov as #NCT00179647.

  • Submitted December 19, 2008.
  • Accepted March 15, 2009.
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