{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:50:37Z","timestamp":1792158637547,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    The extensive use of lenalidomide (Len) in the first\u2010line treatment of multiple myeloma (MM) has resulted in an increased frequency of patients who have been exposed or are refractory to Len (Len\u2010R) at first relapse. However, the outcome of Len\u2010R patients treated at first relapse after autologous haematopoietic stem cell transplantation (AHSCT) remains unclear. The aim of this real\u2010life study is to evaluate the effectiveness of the regimens licensed in Italy and used in a cohort of patients who relapsed during Len maintenance after AHSCT. We collected 306 patients with these features. Considering the different regimens used, most patients received isatuximab\u2013carfilzomib\u2013dexamethasone (Isa\u2010KD) (45.4%) followed by daratumumab\u2013pomalidomide\u2013dexamethasone (D\u2010PD) (19.3%) and daratumumab\u2013bortezomib\u2013dexamethasone (D\u2010VD) (12.4%). Overall, a reduced progression\u2010free survival (PFS) and overall survival (OS) were observed in patients with high\u2010risk disease features at relapse, including high lactate dehydrogenase (LDH) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0003 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001), International Staging System (ISS) \u22652 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001) and early relapse (&lt;12\u2009months from maintenance initiation) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0017 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0009). Considering the type of treatment, anti\u2010cluster of differentiation 38 (CD38) monoclonal antibodies (anti\u2010CD38 MoAb)\u2010based regimen displayed improved survival compared to the other treatment, with Isa\u2010KD reporting the longest PFS (22.8\u2009months). Our data in a homogenous cohort of Len\u2010R patients treated at first relapse demonstrated that the anti\u2010CD38 MoAb\u2010based combinations, particularly Isa\u2010KD, represented the standard of care before the approval of anti\u2010B cell maturation antigen (BCMA) immunotherapy.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70751","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:11:51Z","timestamp":1787058711000},"page":"1704-1714","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Salvage treatment patterns in multiple myeloma patients progressing after lenalidomide maintenance: A real\u2010life study from European Myeloma Network (\n                    <scp>EMN<\/scp>\n                    ) Italy"],"prefix":"10.1111","volume":"209","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3430-6115","authenticated-orcid":false,"given":"Gregorio","family":"Baril\u00e0","sequence":"first","affiliation":[{"name":"Hematology Unit San Bortolo Hospital  Vicenza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8313-8384","authenticated-orcid":false,"given":"Angela","family":"Grassi","sequence":"additional","affiliation":[{"name":"Clinical Research Unit Veneto Institute of Oncology, IOV\u2010IRCCS  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Ruocco","sequence":"additional","affiliation":[{"name":"Department of Medicine (DIMED), Hematology and Clinical Immunology Section Padua University School of Medicine  Padua 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