How I manage frontline transplant-eligible multiple myeloma in Italy

  • Vittorio Montefusco | vittorio.montefusco@asst-santipaolocarlo.it Division of Onco-Hematology, ASST Santi Paolo e Carlo, Milan, Italy.
  • Giovanni Martinelli Division of Onco-Hematology, ASST Santi Paolo e Carlo, Milan, Italy.
  • Claudio Cerchione Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy.

Abstract

The treatment of transplant-eligible multiple myeloma patients in Italy consists in an induction phase based on bortezomib plus thalidomide plus dexamethasone (VTd), followed by a single or tandem autologous stem cell transplantation (ASCT), followed by lenalidomide maintenance. This approach offers an overall response rate of 93% and a CR rate of 58% with acceptable toxicity. Lenalidomide maintenance adds a significant increase in disease control, with a progression free survival after ASCT of 53 months, and an overall survival of 86 months. Second primary malignancies represent the most concerning toxicity of lenalidomide maintenance with a 6.9% incidence. However, the benefit in terms of increased myeloma control largely outweigh this complication. The incorporation of daratumumab in this treatment schema will further improve these clinical results.

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Published
2020-09-21
Keywords:
Multiple myeloma, bortezomib, autologous stem cell transplantation, lenalidomide
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How to Cite
Montefusco, V., Martinelli, G., & Cerchione, C. (2020). How I manage frontline transplant-eligible multiple myeloma in Italy. Hematology Reports, 12(s1). https://doi.org/10.4081/hr.2020.8954