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Lenalidomide plus donor-lymphocytes infusion after allogeneic stem-cell transplantation with reduced-intensity conditioning in patients with high-risk multiple myeloma.
- Source :
-
Experimental hematology [Exp Hematol] 2012 Jul; Vol. 40 (7), pp. 521-7. Date of Electronic Publication: 2012 Mar 23. - Publication Year :
- 2012
-
Abstract
- Myeloma relapse is the main cause of death after allogeneic stem cell transplantation. The aim of our observational study was to evaluate the anti-myeloma effect of lenalidomide followed by donor-lymphocyte infusion (DLI) as post-transplantation adoptive immunotherapy. Twelve patients with refractory myeloma were analyzed. The median age at transplantation was 56 years (range, 46-64 years). All patients received reduced-intensity conditioning. Patients were included if progressive or residual disease was observed at day +100 and if no signs of graft-vs-host disease were evident. DLIs were administered after two cycles of lenalidomide. Median dose of lenalidomide was 15 mg (range, 10-25 mg). Patients received a median of six cycles (range, 1-10 cycles). Nine patients (60%) received an escalating dose of DLI. The 1 and 2-year probability of progression-free survival was 75% and 50%, and overall survival was 83% and 69%, respectively. Median overall survival was not reached and median progression-free survival was 23 months. Lenalidomide is well tolerated after allogeneic stem cell transplantation; the combination with DLI did not cause a higher risk of graft-vs-host disease; an immunological synergistic effect was probably present with this strategy. This combination should be evaluated further in a larger cohort of patients.<br /> (Copyright © 2012 ISEH - Society for Hematology and Stem Cells. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Disease-Free Survival
Female
Graft vs Host Disease mortality
Graft vs Host Disease prevention & control
Humans
Lenalidomide
Male
Middle Aged
Survival Rate
Thalidomide administration & dosage
Transplantation, Homologous
Antineoplastic Agents administration & dosage
Immunotherapy, Adoptive methods
Living Donors
Lymphocyte Transfusion
Multiple Myeloma mortality
Multiple Myeloma therapy
Stem Cell Transplantation
Thalidomide analogs & derivatives
Transplantation Conditioning methods
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2399
- Volume :
- 40
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Experimental hematology
- Publication Type :
- Academic Journal
- Accession number :
- 22446605
- Full Text :
- https://doi.org/10.1016/j.exphem.2012.02.009