Presented in part at the Annual Meeting of the American Society of Hematology, 2009.
Article first published online: 31 MAY 2011
Copyright © 2011 Wiley-Liss, Inc.
American Journal of Hematology
Volume 86, Issue 8, pages 640–645, August 2011
How to Cite
Kumar, S. K., Lacy, M. Q., Hayman, S. R., Stewart, K., Buadi, F. K., Allred, J., Laumann, K., Greipp, P. R., Lust, J. A., Gertz, M. A., Zeldenrust, S. R., Bergsagel, P. L., Reeder, C. B., Witzig, T. E., Fonseca, R., Russell, S. J., Mikhael, J. R., Dingli, D., Rajkumar, S. V. and Dispenzieri, A. (2011), Lenalidomide, cyclophosphamide and dexamethasone (CRd) for newly diagnosed multiple myeloma: Results from a phase 2 trial. Am. J. Hematol., 86: 640–645. doi: 10.1002/ajh.22053
Author Contributions: S.K.K. and S.V.R. designed the clinical trial, enrolled patients, and wrote the manuscript; M.Q.L., S.R.H., K.S., F.K.B., P.R.G., J.A.L., M.A.G., S.V.R., S.R.Z., P.L.B., C.B.R., T.E.W., R.F., S.J.R., J.R.M., D.D., and A.D. enrolled patients and critically reviewed the manuscript; J.A. and K.L. performed the data analysis and reviewed the manuscript.
Conflict of interest: M.Q.L., S.K.K., J.R.M., and A.D. sponsored research funded by Celgene; S.R.H., F.K.B., P.R.G., J.A.L., S.V.R., S.R.Z., P.L.B., C.B.R., T.E.W., R.F., S.J.R., and D.D. have nothing to disclose relevant to current manuscript. K.S., R.F., and M.A.G. have received consulting fees from Celgene. R.F. has received a patent for the prognostication of M.M. based on genetic categorization of the disease.
- Issue published online: 14 JUL 2011
- Article first published online: 31 MAY 2011
- Accepted manuscript online: 18 APR 2011 08:26AM EST
- Manuscript Accepted: 8 APR 2011
- Manuscript Received: 4 APR 2011
- Hematologic Malignancies Program
- NIH. Grant Number: CA90628
- ASCO Career Development Program
- Celgene Corporation
The combination of lenalidomide and low-dose dexamethasone is an effective treatment for multiple myeloma (MM). Addition of alkylating agents to lenalidomide or thalidomide results in increased response rates and deeper responses. We designed this trial to study the combination of cyclophosphamide, lenalidomide, and dexamethasone (CRd) as initial therapy for MM. Fifty-three patients with previously untreated symptomatic MM was enrolled. Patients received 4-week treatment cycles consisting of lenalidomide (25 mg daily for 3 weeks), dexamethasone (40 mg weekly), and cyclophosphamide (300 mg/m2 weekly for 3 weeks). A partial response or better was seen in 85% of patients including 47% with a very good partial response or better. The toxicities were manageable with over 80% of planned doses delivered; six patients went off study for toxicity. The median progression free survival (PFS) for the entire group was 28 months (95% CI: 22.7–32.6) and the overall survival (OS) at 2 years was 87% (95% CI: 78–96). Importantly, 14 patients with high-risk MM had similar PFS and OS as the standard-risk patients (n = 39). CRd is an effective and well-tolerated regimen for upfront therapy of MM with high response rates and excellent 2-year OS, and is suitable for long-term therapy. Am. J. Hematol. 2011. © 2011 Wiley-Liss, Inc.