University of Oulu

Luoma, S., Anttila, P., Säily, M. et al. RVD induction and autologous stem cell transplantation followed by lenalidomide maintenance in newly diagnosed multiple myeloma: a phase 2 study of the Finnish Myeloma Group. Ann Hematol 98, 2781–2792 (2019).

RVD induction and autologous stem cell transplantation followed by lenalidomide maintenance in newly diagnosed multiple myeloma : a phase 2 study of the Finnish Myeloma Group

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Author: Luoma, Sini1; Anttila, Pekka1; Säily, Marjaana2;
Organizations: 1Comprehensive Cancer Center, Department of Hematology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2Hematology-Oncology Unit, Oulu University Hospital, Oulu, Finland
3Department of Clinical Chemistry and TYKSLAB, University of Turku and Turku University Hospital, Turku, Finland
4Hematology Unit, Turku University Hospital, Turku, Finland
5Department of Medicine, Satakunta Central Hospital, Pori, Finland
6Hematology Unit, Tampere University Hospital, Tampere, Finland
7Department of Medicine, Kuopio University Hospital, Kuopio, Finland
8Department of Medicine, Mikkeli Central Hospital, Mikkeli, Finland
9Department of Medicine, Länsi-Pohja Central Hospital, Kemi, Finland
10Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
11Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
12Department of Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland
13Department of Medicine, Kainuu Central Hospital, Kajaani, Finland
14Science Service Center, Kuopio University Hospital, Kuopio, Finland
15Fimlab Laboratories Ltd., Tampere, Finland
16HUSLAB Helsinki University Hospital, Helsinki, Finland
17NordLab Oulu, Oulu University Hospital, Oulu, Finland
18Laboratory of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
19Institute of Clinical Medicine/Internal Medicine, University of Eastern Finland, Kuopio, Finland
20Department of Medicine, North Carelia Hospital District, Joensuu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2020-03-26


Autologous stem cell transplantation (ASCT) combined with novel agents is the standard treatment for transplant-eligible, newly diagnosed myeloma (NDMM) patients. Lenalidomide is approved for maintenance after ASCT until progression, although the optimal duration of maintenance is unknown. In this trial, 80 patients with NDMM received three cycles of lenalidomide, bortezomib, and dexamethasone followed by ASCT and lenalidomide maintenance until progression or toxicity. The primary endpoint was the proportion of flow-negative patients. Molecular response was assessed if patients were flow-negative or in stringent complete response (sCR). By intention to treat, the overall response rate was 89%. Neither median progression-free survival nor overall survival (OS) has been reached. The OS at 3 years was 83%. Flow-negativity was reached in 53% and PCR-negativity in 28% of the patients. With a median follow-up of 27 months, 29 (36%) patients are still on lenalidomide and 66% of them have sustained flow-negativity. Lenalidomide maintenance phase was reached in 8/16 high-risk patients but seven of them have progressed after a median of only 6 months. In low- or standard-risk patients, the outcome was promising, but high-risk patients need more effective treatment approach. Flow-negativity with the conventional flow was an independent predictor for longer PFS.

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Series: Annals of hematology
ISSN: 0939-5555
ISSN-E: 1432-0584
ISSN-L: 0939-5555
Volume: 98
Issue: 12
Pages: 2781 - 2792
DOI: 10.1007/s00277-019-03815-7
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: Open access funding provided by University of Helsinki including Helsinki University Central Hospital. Celgene, Research Committee of the Kuopio University Hospital catchment area, and Helsinki University Hospital Comprehensive Cancer Center supported the study by research funding (Kuopio University Hospital, Finland 5101424 and Helsinki University Hospital, Finland Y1018XPA01).
Copyright information: © The Authors 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.