{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:15:45Z","timestamp":1767863745478,"version":"3.49.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer J."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Refractoriness to lenalidomide is an important factor determining the choice of therapy at first relapse in multiple myeloma (MM). It remains debatable if resistance to lenalidomide varies among MM refractory to standard doses vs low dose maintenance doses. In this study, we assessed the outcomes with subsequent therapies in patients with MM refractory to standard dose vs low dose lenalidomide. We retrospectively reviewed all patients with MM at our institution who received first line therapy with lenalidomide containing regimens, and assessed progression free survival (PFS) and overall survival for these patients for second line therapy, and with lenalidomide retreatment. For second line therapy, we found no difference in the PFS between standard dose refractory and low dose refractory groups (median PFS 14 months vs 14 months, <jats:italic>p<\/jats:italic>\u2009=\u20090.95), while the PFS for both these groups was inferior to the not refractory group (median PFS 30 months, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 for both pairs). Similar trends were seen among these groups on lenalidomide retreatment, and on multivariable analysis. These data suggest that refractoriness to lenalidomide is not dose dependent, and definition of lenalidomide refractoriness should not depend on the dose of lenalidomide to which the disease was considered refractory.<\/jats:p>","DOI":"10.1038\/s41408-024-01039-1","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T12:02:48Z","timestamp":1711454568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes of patients with multiple myeloma refractory to standard dose vs low dose lenalidomide"],"prefix":"10.1038","volume":"14","author":[{"given":"Utkarsh","family":"Goel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charalampos","family":"Charalampous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4342-364X","authenticated-orcid":false,"given":"Prashant","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9014-9658","authenticated-orcid":false,"given":"Moritz","family":"Binder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3214-0203","authenticated-orcid":false,"given":"Francis K.","family":"Buadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7477-3004","authenticated-orcid":false,"given":"David","family":"Dingli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-9512","authenticated-orcid":false,"given":"Angela","family":"Dispenzieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amie","family":"Fonder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3853-5196","authenticated-orcid":false,"given":"Morie A.","family":"Gertz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson I.","family":"Gonsalves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne R.","family":"Hayman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam A.","family":"Hobbs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi L.","family":"Hwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8573-9434","authenticated-orcid":false,"given":"Taxiarchis","family":"Kourelis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Q.","family":"Lacy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson","family":"Leung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1556-6416","authenticated-orcid":false,"given":"Yi","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahma M.","family":"Warsame","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Kyle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5862-1833","authenticated-orcid":false,"given":"S. Vincent","family":"Rajkumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5392-9284","authenticated-orcid":false,"given":"Shaji K.","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"1039_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-022-00695-5","volume":"12","author":"S Kumar","year":"2022","unstructured":"Kumar S, Baizer L, Callander NS, Giralt SA, Hillengass J, Freidlin B, et al. Gaps and opportunities in the treatment of relapsed-refractory multiple myeloma: Consensus recommendations of the NCI Multiple Myeloma Steering Committee. Blood Cancer J. 2022;12:98.","journal-title":"Blood Cancer J"},{"key":"1039_CR2","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1002\/ajh.26590","volume":"97","author":"SV Rajkumar","year":"2022","unstructured":"Rajkumar SV. Multiple myeloma: 2022 update on diagnosis, risk stratification, and management. Am J Hematol. 2022;97:1086\u2013107.","journal-title":"Am J Hematol"},{"key":"1039_CR3","doi-asserted-by":"publisher","first-page":"4095","DOI":"10.1182\/bloodadvances.2019000539","volume":"3","author":"E Kastritis","year":"2019","unstructured":"Kastritis E, Roussou M, Gavriatopoulou M, Kanellias N, Migkou M, Eleutherakis-Papaiakovou E, et al. Impact of last lenalidomide dose, duration, and IMiD-free interval in patients with myeloma treated with pomalidomide\/dexamethasone. Blood Adv. 2019;3:4095\u2013103.","journal-title":"Blood Adv"},{"key":"1039_CR4","doi-asserted-by":"crossref","unstructured":"Laubach J. Multiple myeloma: Treatment of first or second relapse. 2022 10\/17\/2022. In: UpToDate [Internet]. Waltham, MA (Accessed on December 4, 2022): UpToDate.","DOI":"10.1097\/01.NPR.0000873556.24995.ba"},{"key":"1039_CR5","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.1182\/blood-2016-07-729236","volume":"128","author":"IS Nijhof","year":"2016","unstructured":"Nijhof IS, Franssen LE, Levin MD, Bos GMJ, Broijl A, Klein SK, et al. Phase 1\/2 study of lenalidomide combined with low-dose cyclophosphamide and prednisone in lenalidomide-refractory multiple myeloma. Blood. 2016;128:2297\u2013306.","journal-title":"Blood"},{"key":"1039_CR6","doi-asserted-by":"publisher","first-page":"e105","DOI":"10.1016\/S1470-2045(20)30756-7","volume":"22","author":"P Moreau","year":"2021","unstructured":"Moreau P, Kumar SK, San Miguel J, Davies F, Zamagni E, Bahlis N, et al. Treatment of relapsed and refractory multiple myeloma: recommendations from the International Myeloma Working Group. 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Mayo Clin Proc. 2013;88:360\u201376.","journal-title":"Mayo Clin Proc"},{"key":"1039_CR11","doi-asserted-by":"publisher","first-page":"4691","DOI":"10.1182\/blood-2010-10-299487","volume":"117","author":"SV Rajkumar","year":"2011","unstructured":"Rajkumar SV, Harousseau J-L, Durie B, Anderson KC, Dimopoulos M, Kyle R, et al. Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1. Blood. 2011;117:4691\u20135.","journal-title":"Blood"}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01039-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01039-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01039-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T12:02:56Z","timestamp":1711454576000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41408-024-01039-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,26]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1039"],"URL":"https:\/\/doi.org\/10.1038\/s41408-024-01039-1","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,26]]},"assertion":[{"value":"12 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"PK: Sanofi, BMS, Abbvie (Honoraria and Research Funding), Regeneron, Amgen, Ichnos, Loxo, Karyopharma, Takeda (Research Funding), Casma, Pharamcyclics, Imedex, GSK, Cellectar, Oncopeptides, X4 Pharmaceuticals (Honoraria). DD: Alexion, Apellis, BMS, Novartis, Roche, Sanofi (Consultancy), Regeneron (Research Funding). AD: Alynlam, Pfizer, Takeda, BMS (Research Funding), Janssen (Membership on an entity\u2019s Board of Directors or advisory committees), Oncopeptides, Sorrento (Data monitoring safety committee). MAG: Ionis\/Akcea, Prothena, Sanofi, Janssen, Aptitude Healthgrants, Ashfield, Juno, Physicians Education Resource, Johnson & Johnson, Celgene, Research to Practice, Sorrento (Personal Fees), Abbvie (Membership on an entity\u2019s Board of Directors or advisory committees and Data monitoring safety committee), i3Health (Development of educational materials), TK: Novartis (Research Funding), MQL: Celgene (Research Funding), NL: Takeda (Membership on an entity\u2019s Board of Directors or advisory committees), YL: Bluebird Bio, Celgene, Janssen, Kite (Consultancy and Research Funding), Gamida Cell, Novartis, Juno, Legend, Sorrento, Vineti (Consultancy), Merck, Takeda (Research Funding), Abbvie, Celgene, Janssen, Takeda, Adaptive, MedImmune\/Astra Zeneca (Membership on an entity\u2019s Board of Directors or advisory committees), Kite, Merck, Novartis, Roche, Sanofi (Research Funding), Oncopeptides (Independent review committee). The remaining authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"55"}}