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Treatment options are limited in myeloma relapsed or refractory to both bortezomib and lenalidomide (double-relapsed/refractory multiple myeloma; DRMM). Bendamustine is an antitumour agent that has efficacy in relapsed myeloma. We retrospectively analysed data from 30 DRMM patients who received a combination of bendamustine, thalidomide and dexamethasone (BTD) in 28-day treatment cycles. Bendamustine was administered with a cumulative dose of up to 200 mg/m(2). Thalidomide (50-150 mg) was given daily as tolerated, and dexamethasone was given at an equivalent dose of up to 160 mg per cycle. A median of 5 (2-9) treatment cycles were administered per patient. Twenty-six patients (87 %) achieved stable disease or better. At a median follow-up time of 12.1 (2.3-21.5) months, median (95 % CI) progression-free survival and overall survival were 4.0 (2.6-5.3) months and 7.2 (5.2-9.2) months, respectively. The most common grade 3-4 adverse events were haematological: anaemia (n = 8, 34.8 %), neutropenia (n = 16, 69.6 %) and thrombocytopenia (n = 10, 43.5 %). Non-haematological toxicities included pain (n = 3, 13.0 %), infection (n = 7, 30.4 %) and sensory neuropathy (n = 1, 4.3 %). We propose that BTD is a viable salvage treatment option for DRMM patients.

Original publication

DOI

10.1007/s00277-014-2238-2

Type

Journal article

Journal

Ann Hematol

Publication Date

04/2015

Volume

94

Pages

643 - 649

Keywords

Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Bendamustine Hydrochloride, Boronic Acids, Bortezomib, Dexamethasone, Female, Humans, Lenalidomide, Male, Middle Aged, Multiple Myeloma, Nitrogen Mustard Compounds, Pyrazines, Recurrence, Retrospective Studies, Salvage Therapy, Survival Analysis, Thalidomide, Treatment Failure