Lenalidomide plus donor-lymphocytes infusion after allogeneic stem-cell transplantation with reduced-intensity conditioning in patients with high-risk multiple myeloma

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• 作者：Jean El-Cheikh^a ; ^{elcheikhj@marseille.fnclcc.fr} ; Roberto Crocchiolo^a ; Sabine Furst^a ; Patrick Ladaique^b ; Luca Castagna^a ; Catherine Faucher^a ; Angela Granata^a ; Claire Oudin^a ; Claude Lemarie^b ; Boris Calmels^b ; Anne-Marie Stoppa^c ; Jean-Marc Schiano De Colella^c ; Segolene Duran^d ; Christian Chabannon^b ; Didier Blaise^a
• 刊名：Experimental Hematology
• 出版年：2012
• 出版时间：July, 2012
• 年：2012
• 卷：40
• 期：7
• 页码：521-527
• 全文大小：337 K

文摘

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.