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Introduction: Relapsed/refractory multiple myeloma (RRMM) is a challenging setting for management and treatment. In Poland, a substantial fraction of RRMM patients is currently treated with lenalidomide and dexamethasone (Rd). Establishing predictors of treatment-related complications and poor response is crucial for further optimal therapeutic decision-making. Material and methods: This retrospective study included all patients who received the Rd regimen according to the Ministry of Health's drug reimbursement program (B.54) between January 2017 and December 2021 in the Department of Hematology, Medical University of Lodz, Poland. Results: The study group consisted of 174 patients, and the mean age was 67.3 ± 9.0 years. The majority of patients (63.2%) received the Rd at the first relapse//progression. The median PFS was 12.6 months, and the median OS was 22.3 months. The overall response rate was 64.1%, 12.7% achieved complete response (CR), and 20.4% had a very good partial response (VGPR). In multivariate Cox regression analysis for PFS, ISS 3 (HR 1.8, 95% CI: 1.2-2.7, p = 0.0062) and CR/VGPR after 6. cycle (HR 0.4, 95% CI: 0.2-0.9, p = 0.0222) were independent prognostic factors. Similarly, ISS 3 (HR 2.1, 95% CI: 1.3-3.3, p = 0.0012) was related to poorer OS, whereas CR//VGPR achievement was related to improved OS (HR 0.4, 95% CI: 0.2-0.9, p = 0.0238). The most prevalent adverse events in the study group were serious infections (31.0%), neutropenia (28.7%), thrombocytopenia (18.4%), anemia (18.1%) and thromboembolic events (11.5%). In multivariate logistic regression analysis, hypoalbuminemia (OR 4.2, 95% CI: 1.6-11.2, p = 0.0039), ASCT before Rd (OR 2.6, 95% CI: 1.0-6.7, p = 0.048) and anemia (OR 5.0, 95% CI: 1.8-14.0, p = 0.002) were independent factors related to the occurrence of serious infections. Conclusions: RRMM patients with ISS 3 and who did not achieve CR/VGPR have inferior outcomes following Rd and should be candidates for novel drug administration or enrolled in clinical trials. Patients after ASCT, with hypoalbuminemia or anemia during Rd treatment are at risk of serious infectious complications. [ABSTRACT FROM AUTHOR]

Introduction: The systemic inflammation index (SII) might serve as an indicator of the equilibrium between the inflammatory and immune responses. The aim of the study was to determine the clinical value and prognostic significance of SII in the cohort of multiple myeloma (MM) patients treated with a regimen of pomalidomide and dexamethasone (Pd)., Material and Methods: This retrospective, real-life study included patients who received a Pd regimen in our centre between November 2018 and July 2022. The systemic inflammation index was calculated from peripheral blood counts of platelets, neutrophils, and lymphocytes collected shortly before commencement of Pd treatment using the equation: SII = N × P/L, where N, P, and L are the respective counts per litre of peripheral blood for neutrophils, platelets, and lymphocytes., Results: The study group consisted of 54 patients. Most patients received Pd as the third (38.9%) or fourth (37.0%) line of treatment. The median number of completed treatment cycles was 5 (IQR: 1-12). The median progression-free survival (PFS) was 6.8 months and overall survival (OS) 14.8 months. High SII (> 374) was an independent prognostic factor for PFS (HR = 3.0, 95% CI: 1.4-6.3, p < 0.01) and OS (HR = 2.2, 95% CI: 1.0-4.6, p = 0.04). In the low SII group, the respective median PFS and OS values were 9.6 and 21.7 months, compared to 2.6 ( p = 0.018) and 5.5 months ( p = 0.035) in the high SII group., Conclusions: The systemic inflammation index has prognostic significance in MM patients treated with Pd. A high SII predicts a poorer outcome in pretreated MM patients undergoing Pd treatment evaluation. As such, it may well be a key factor for guiding subsequent treatment decisions., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Termedia.)