974P - Prospective study of melphalan, prednisolone and lenalidomide in the treatment of elderly patients with newly diagnosed multiple myeloma

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Plasma Cell Dyscrasias
Geriatric Oncology
Biological Therapy
Presenter Abdul Shahid
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors A. Shahid, G. Narayanan, S. Nair, S. Prem
  • Dept. Of Medical Oncology, Regional Cancer Centre Thiruvananthapuram/Trivandrum, 695011 - Thiruvananthapuram (Trivandrum)/IN



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.


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).


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 < 10gm% and 15 had raised Serum creatinine. Nineteen patients had ISS Stage 1, 14 patients had ISS Stage 2 and 22 had ISS Stage 3. Thirty eight patients had IgG myeloma, 2 had IgA, 7 had only light chain disease, and 2 were non secretory. Response was assessed at 6 months of MPL, 27 achieved very good partial response or more, 10 achieved partial response,1 stable disease and 2 had progressive disease. Four patients developed pneumonitis, 2 developed hypersensitivity, one had deep vein thrombosis and four patients died during this period.


MPL is a safe, well tolerated and effective chemotherapy in elderly patients with multiple myeloma.


All authors have declared no conflicts of interest.