Approximately 10% to 15% of patients with newly diagnosed multiple myeloma (MM) and normal renal function are exceptional responders to lenalidomide-dexamethasone (Rd) therapy, according to a study of 240 patients with newly diagnosed MM, including 33 patients identified as exceptional responders. Researchers found that among those exceptional responders:

• 25 received primary Rd therapy and 8 received Rd induction followed by stem cell transplantation.

• 45% had known clonal plasma cell disorder before MM diagnosis.

• Lytic lesions were the dominant mode of clinical presentation in 28.

• In 24 with informative cytogenetics, trisomes were present in 19, including 1 patient with concurrent trisomes and t(11;14).

• Overall, 21 of 24 had either trisomes or t(11;14).

• None of the exceptional responders had high-risk cytogenetic features at baseline.

• 25 achieved a complete response, and 8 achieved the exceptional response state without ever achieving a complete response.

Citation: Vu T, Gonsalves W, Kumar S, et al. Characteristics of exceptional responders to lenalidomide-based therapy in multiple myeloma. Blood Cancer J. 2015 Oct 23;5:e363. doi: 1038/bcj.2015.91.