{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:56:24Z","timestamp":1782950184387,"version":"3.54.5"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BMS","award":["#20199"],"award-info":[{"award-number":["#20199"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Scarce data exist on double maintenance in transplant-eligible high-risk (HR) newly diagnosed multiple myeloma (NDMM) patients. This prospective phase 2 study enrolled 120 transplant-eligible NDMM patients. The treatment consisted of four cycles of ixazomib\u2013lenalidomide\u2013dexamethasone (IRD) induction plus autologous stem cell transplantation followed by IRD consolidation and cytogenetic risk-based maintenance therapy with lenalidomide + ixazomib (IR) for HR patients and lenalidomide (R) alone for NHR patients. The main endpoint of the study was undetectable minimal residual disease (MRD) with sensitivity of &lt;10\u22125 by flow cytometry at any time, and other endpoints were progression-free survival (PFS) and overall survival (OS). We present the preplanned analysis after the last patient has been two years on maintenance. At any time during protocol treatment, 28% (34\/120) had MRD &lt; 10\u22125 at least once. At two years on maintenance, 66% of the patients in the HR group and 76% in the NHR group were progression-free (p = 0.395) and 36% (43\/120) were CR or better, of which 42% (18\/43) had undetectable flow MRD &lt;10\u22125. Altogether 95% of the patients with sustained MRD &lt;10\u22125, 82% of the patients who turned MRD-positive, and 61% of those with positive MRD had no disease progression at two years on maintenance (p &lt; 0.001). To conclude, prolonged maintenance with all-oral ixazomib plus lenalidomide might improve PFS in HR patients.<\/jats:p>","DOI":"10.3390\/cancers16051024","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T03:31:23Z","timestamp":1709263883000},"page":"1024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ixazomib, Lenalidomide, and Dexamethasone (IRD) Treatment with Cytogenetic Risk-Based Maintenance in Transplant-Eligible Myeloma: A Phase 2 Multicenter Study by the Nordic Myeloma Study Group"],"prefix":"10.3390","volume":"16","author":[{"given":"Anu","family":"Partanen","sequence":"first","affiliation":[{"name":"Department of Medicine, Kuopio University Hospital, 70210 Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Waage","sequence":"additional","affiliation":[{"name":"Department of Hematology, St. Olavs Hospital, 7030 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valdas","family":"Peceliunas","sequence":"additional","affiliation":[{"name":"Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital, 08661 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1096-0569","authenticated-orcid":false,"given":"Fredrik","family":"Schjesvold","sequence":"additional","affiliation":[{"name":"Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, 0450 Oslo, Norway"},{"name":"KG Jebsen Center for B Cell Malignancies, University of Oslo, 0316 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-0657","authenticated-orcid":false,"given":"Pekka","family":"Anttila","sequence":"additional","affiliation":[{"name":"Helsinki University Hospital Cancer Center Hematology, University of Helsinki, 00029 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjaana","family":"S\u00e4ily","sequence":"additional","affiliation":[{"name":"Hematology-Oncology Unit, Oulu University Hospital Hematology, 90220 Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Uttervall","sequence":"additional","affiliation":[{"name":"Medical Unit Hematology, Karolinska University Hospital, 171 64 Solna, Sweden"},{"name":"Department of Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervi","family":"Putkonen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Turku University Hospital, 20521 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0303-1350","authenticated-orcid":false,"given":"Kristina","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Hematology, Uppsala University Hospital, 751 85 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einar","family":"Haukas","sequence":"additional","affiliation":[{"name":"Stavanger University Hospital, 4011 Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"Sankelo","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Internal Medicine, Tampere University Hospital Hematology, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Szatkowski","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hematology and Palliative Care, Foerde Central Hospital, 6812 Foerde, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7715-4548","authenticated-orcid":false,"given":"Markus","family":"Hansson","sequence":"additional","affiliation":[{"name":"Department of Hematology, Sk\u00e5ne University Hospital, 222 42 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Marttila","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kymenlaakso Central Hospital, 48210 Kotka, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Hematology, Link\u00f6ping University Hospital, 581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Department of Haematology, Helsingborg Hospital, 252 23 Helsingborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Lauri","sequence":"additional","affiliation":[{"name":"Department of Hematology, Sunderby Hospital, 971 80 Lule\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maija","family":"Mikkola","sequence":"additional","affiliation":[{"name":"Department of Medicine, P\u00e4ij\u00e4t-H\u00e4me Central Hospital, 15850 Lahti, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conny","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Department of Haematology, Halland Hospital, 302 33 Halmstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Abelsson","sequence":"additional","affiliation":[{"name":"Department of Hematology, Uddevalla Hospital, 451 53 Uddevalla, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1928-7518","authenticated-orcid":false,"given":"Erik","family":"Ahlstrand","sequence":"additional","affiliation":[{"name":"Department of Medicine, \u00d6rebro University Hospital, 701 85 \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Siki\u00f6","sequence":"additional","affiliation":[{"name":"Department of Medicine, Central Finland Central Hospital, 40620 Jyv\u00e4skyl\u00e4, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3391-930X","authenticated-orcid":false,"given":"Monika","family":"Klimkowska","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Cytology, Karolinska University Hospital, 141 86 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reda","family":"Matuzeviciene","sequence":"additional","affiliation":[{"name":"Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Biomedical Sciences Institute, Vilnius University Hospital and Vilnius University Faculty of Medicine, 03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9102-8409","authenticated-orcid":false,"given":"Mona Hoysaeter","family":"Fenstad","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine, St. Olavs Hospital, 7030 Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorella","family":"Ilveskero","sequence":"additional","affiliation":[{"name":"Clinical Chemistry, Helsinki University Hospital, University of Helsinki, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarja-Terttu","family":"Pelliniemi","sequence":"additional","affiliation":[{"name":"Fimlab Laboratories Ltd., 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-5094","authenticated-orcid":false,"given":"Hareth","family":"Nahi","sequence":"additional","affiliation":[{"name":"Hematology 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