Prospective Study of Melphalan, Prednisolone and Lenalidomide in the Treatment of Elderly Patients with Newly Diagnosed Multiple Myeloma

Abstract

ABSTRACT Introduction: The median survival of patients with multiple myeloma has improved in recent years with the advent of newer agents. Combination of melphalan, prednisolone and thalidomide is considered the standard of care in elderly patients. Present study looks at the role of lenalidamide along with melphalan and prednisolone (MPL) in elderly patients with myeloma. Aim: To assess the response of MPL chemotherapy in elderly patients with newly diagnosed multiple myeloma and the tolerance to MPL in these patients. Methods: This is a prospective study of newly diagnosed multiple myeloma patients above 60 yrs and ineligible for peripheral blood stem cell transplant and attending medical oncology department at Regional Cancer Centre, Trivandrum, India.The recruitment period was from January 2012 to September 2013. The study was approved by Institute Ethics committee. Baseline physical examination, laboratory tests and myeloma specific tests were done at the entry. All patients received oral melphalan and prednisone from Day 1 to 4, and lenalidomide from Day 1 to 21 of each 28 day cycle. After 6 cycles of MPL, patients who achieved CR/VGPR received maintenance with lenalidomide until any sign of relapse or progression or 1 year whichever is earlier. Response to treatment was assessed every 3 months (IMWG criteria). Results: Fifty five patients above 60 years of age were enrolled after informed consent. There were 30 males and 25 females. The median age was 67 years. Twenty three patients had a haemoglobin of Conclusions: MPL is a safe, well tolerated and effective chemotherapy in elderly patients with multiple myeloma. Disclosure: All authors have declared no conflicts of interest.