Biologically defined risk groups can be used to define the impact of thalidomide maintenance therapy in newly diagnosed multiple myeloma

Brioli, Annamaria, Kaiser, Martin F., Pawlyn, Charlotte, Wu, Ping, Gregory, Walter M., Owen, Roger, Ross, Fiona M., Jackson, Graham H., Cavo, Michele, Davies, Faith E. and Morgan, Gareth J. (2013) Biologically defined risk groups can be used to define the impact of thalidomide maintenance therapy in newly diagnosed multiple myeloma. Leukemia and Lymphoma, 54 (9), 1975-1981. (doi:10.3109/10428194.2012.760736). (PMID:23270579)

Abstract

Maintenance therapy is an attractive strategy for Multiple Myeloma patients. However the impact of maintenance thalidomide according to the underlying biology of the disease is still a matter of debate, with some studies suggesting that thalidomide is more beneficial in high risk disease, whilst others show the opposite. Biological risk groups defined by interphase fluorescence in situ hybridisation (FISH) are powerful predictors of outcome. In this report we investigated the effect of maintenance thalidomide in different biological risk groups defined by different FISH categories. Our data show that maintenance thalidomide improves outcome in patients with biologically low risk disease, defined by the absence of adverse cytogenetic lesion or by the presence of hyperdiploidy alone. Conversely thalidomide maintenance is detrimental for overall survival of patients with biological high risk. We conclude that it is important to identify biologically low risk patients that will benefit from a maintenance strategy with thalidomide

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