{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:00:47Z","timestamp":1792868447915,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,10,15]],"date-time":"2013-10-15T00:00:00Z","timestamp":1381795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:p>The combination of lenalidomide plus dexamethasone (RD) is very effective for patients with relapsed\/refractory myeloma. However, the effect of RD on bone metabolism has not been previously evaluated in these patients. To address this issue, we initially performed a retrospective study in 106 consecutive patients with relapsed or refractory myeloma who received RD. We measured the following bone indices on Cycle 1\/Day 1 and then on Cycles 3 and 6\/Day 28: dickkopf\u20101 (Dkk\u20101), sRANKL, osteoprotegerin (OPG), bone resorption markers (C\u2010telopeptide of collagen type\u2010I, CTX and TRACP\u20105b) and bone formation markers (bone\u2010specific alkaline phosphatase\u2010bALP and osteocalcin). RD produced a reduction of CTX only in responders, with no effect on bone formation. To validate these results, we then evaluated prospectively 99 patients who received either RD (<jats:italic>n<\/jats:italic>\u2009=\u200950) or VRD (bortezomib + RD, <jats:italic>n<\/jats:italic>\u2009=\u200949). RD reduced CTX, mainly in responders but showed no effect on bone formation, confirming the result of the retrospective study. However, the addition of bortezomib to RD (VRD arm) reduced Dkk\u20101, sRANKL\/OPG, and CTX, while it increased bALP and OC after six cycles of therapy. These changes were irrespective of treatment response, which was similar between treatment arms. No skeletal\u2010related events were observed in the VRD arm while two, nonresponding patients treated with RD developed a vertebral fracture. We conclude that RD reduces bone resorption only in responding patients with relapsed\/refractory myeloma but has no effect on bone formation. Combination with bortezomib, which enhances bone formation, seems to be preferred for the management of myeloma patients with osteolytic disease. Am. J. Hematol. 89:34\u201340, 2014. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23577","type":"journal-article","created":{"date-parts":[[2013,8,26]],"date-time":"2013-08-26T09:02:38Z","timestamp":1377507758000},"page":"34-40","source":"Crossref","is-referenced-by-count":34,"title":["The combination of lenalidomide and dexamethasone reduces bone resorption in responding patients with relapsed\/refractory multiple myeloma but has no effect on bone formation: Final results on 205 patients of the Greek myeloma study group"],"prefix":"10.1002","volume":"89","author":[{"given":"Evangelos","family":"Terpos","sequence":"first","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Christoulas","sequence":"additional","affiliation":[{"name":"Department of Hematology 251 General Air Force Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Kastritis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Katodritou","sequence":"additional","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Papatheodorou","sequence":"additional","affiliation":[{"name":"Department of Medical Research 251 General Air Force Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Pouli","sequence":"additional","affiliation":[{"name":"Department of Hematology St Savvas Oncology Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Christine","family":"Kyrtsonis","sequence":"additional","affiliation":[{"name":"Hematology Section and Laboratory First Department of Propaedeutic Medicine, School of Medicine, National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eurydiki","family":"Michalis","sequence":"additional","affiliation":[{"name":"Department of Hematology, \u201cGeorgios Gennimatas\u201d General Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xenophon","family":"Papanikolaou","sequence":"additional","affiliation":[{"name":"Department of Hematology Metaxa Cancer Hospital Piraeus Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gkotzamanidou","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Koulieris","sequence":"additional","affiliation":[{"name":"Hematology Section and Laboratory First Department of Propaedeutic Medicine, School of Medicine, National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gavriatopoulou","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Zervas","sequence":"additional","affiliation":[{"name":"Department of Hematology Theagenio Cancer Hospital Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meletios A.","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Greek Myeloma Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-10-078022"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.402"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070594"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070596"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.4065\/78.1.21"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04712.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.336"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-09-2684"},{"key":"e_1_2_5_10_1","first-page":"287","article-title":"Recombinant osteoprotegerin decreases tumor burden and increases survival in a murine model of multiple myeloma","volume":"63","author":"Vanderkerken K","year":"2003","journal-title":"Cancer Res"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-02-0380"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9440(10)63560-2"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030847"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22033"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2008.01065.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404843"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2006.06356.x"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2010.031302"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2011.01599.x"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-08-3450"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403890"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0902-4441.2005.t01-1-EJH2520.x"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.174"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-012-1058-1"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2010.175"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2404284"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.147"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112704"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2009.03.111"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1006\/bbrc.2002.6510"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-010-0477-8"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-07-4568"},{"key":"e_1_2_5_33_1","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1182\/blood.V116.21.1928.1928","article-title":"DKK1 is an immediate early gene in multiple myeloma cells modulated by cell density and IL\u20106","volume":"116","author":"Tian E","year":"2010","journal-title":"Blood"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2004.04.025"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq259"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.23577","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.23577","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T15:34:04Z","timestamp":1696606444000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.23577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,15]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1002\/ajh.23577"],"URL":"https:\/\/doi.org\/10.1002\/ajh.23577","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,15]]}}}