Meletios A Dimopoulos

National and Kapodistrian University of Athens, Athínai, Attica, Greece

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Publications (576)3524.78 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Survival for patients with multiple myeloma has increased. Both melphalan and lenalidomide are associated with subsequent development of myelodysplasia. We reviewed the cases of all patients with multiple myeloma who had subsequent development of myelodysplastic syndrome (MDS) or acute nonlymphoblastic leukemia (ANLL) during a 12-year period in 3 centers. Of 55 patients identified, 2 received only lenalidomide before myelodysplasia developed. The median time between the diagnoses of multiple myeloma and MDS/ANLL was 52.7 months. Median survival after the diagnosis of MDS or ANLL was 6.7 months. Treatment of the MDS comprised allogeneic stem cell transplant in 8 patients (median survival, 219 days; 1 patient alive at 624 days) and a hypomethylating agent in 21 patients (response of stable or better in 5 patients). Myelodysplasia remains a devastating complication of therapy for multiple myeloma, with short survival and poor response rates to available modalities.
    Leukemia and Lymphoma 10/2014; DOI:10.3109/10428194.2014.970543 · 2.61 Impact Factor
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    ABSTRACT: Objective To evaluate the prognostic role of cytoreductive nephrectomy (CN) in patients with metastatic RCC (mRCC) and synchronous metastases, treated with the vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor (TKI) sunitinib. Patients and Methods Patients with a diagnosis of metastases prior to, at the time of or within 3 months from the diagnosis of RCC and 1st-line treatment with sunitinib were included. Baseline characteristics were correlated with overall survival (OS) were through hazard ratios (HRs) estimated from univariate Cox proportional hazards models. Significant factors were then included in a multivariate Cox proportional hazards model. Results 186 patients treated between 1/2006-3/2012 were selected. 36 (19%) had not undergone CN. CN was offered to younger patients with better prognosis. Patients who underwent CN lived significantly longer than patients without CN (median OS 23.9 [95% CI: 20.8-28.8] vs. 9 [95% CI: 4-16.4] months, p<0.001). Multivariate analysis showed that CN had an independent prognostic significance. No specific subgroup benefiting from CN was identified. Conclusion CN was an independent favorable prognostic factor in patients with synchronous metastases from RCC, treated with sunitinib. Information regarding the selection of mRCC patients likely to benefit from CN may be derived by ongoing phase III trials.
    Clinical Genitourinary Cancer 10/2014; 12(5). DOI:10.1016/j.clgc.2014.03.012 · 1.69 Impact Factor
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    ABSTRACT: To determine the more effective dosing sequence of intermittent erlotinib and docetaxel for treating chemotherapy-naive patients with advanced Non-Small Cell Lung Cancer (NSCLC).
    Anticancer research 10/2014; 34(10):5649-55. · 1.87 Impact Factor
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    ABSTRACT: BACKGROUND: Panobinostat is a potent oral pan-deacetylase inhibitor that in preclinical studies has synergistic anti-myeloma activity when combined with bortezomib and dexamethasone. We aimed to compare panobinostat, bortezomib, and dexamethasone with placebo, bortezomib, and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma. METHODS: PANORAMA1 is a multicentre, randomised, placebo-controlled, double-blind phase 3 trial of patients with relapsed or relapsed and refractory multiple myeloma who have received between one and three previous treatment regimens. Patients were randomly assigned (1:1) via an interactive web-based and voice response system, stratified by number of previous treatment lines and by previous use of bortezomib, to receive 21 day cycles of placebo or panobinostat (20 mg; on days 1, 3, 5, 8, 10, 12, orally), both in combination with bortezomib (1·3 mg/m(2) on days 1, 4, 8, 11, intravenously) and dexamethasone (20 mg on days 1, 2, 4, 5, 8, 9, 11, 12, orally). Patients, physicians, and the investigators who did the data analysis were masked to treatment allocation; crossover was not permitted. The primary endpoint was progression-free survival (in accordance with modified European Group for Blood and Marrow Transplantation criteria and based on investigators' assessment) and was analysed by intention to treat. The study is ongoing, but no longer recruiting, and is registered at ClinicalTrials.gov, number NCT01023308. FINDINGS: 768 patients were enrolled between Jan 21, 2010, and Feb 29, 2012, with 387 randomly assigned to panobinostat, bortezomib, and dexamethasone and 381 to placebo, bortezomib, and dexamethasone. Median follow-up was 6·47 months (IQR 1·81-13·47) in the panobinostat group and 5·59 months (2·14-11·30) in the placebo group. Median progression-free survival was significantly longer in the panobinostat group than in the placebo group (11·99 months [95% CI 10·33-12·94] vs 8·08 months [7·56-9·23]; hazard ratio [HR] 0·63, 95% CI 0·52-0·76; p<0·0001). Overall survival data are not yet mature, although at the time of this analysis, median overall survival was 33·64 months (95% CI 31·34-not estimable) for the panobinostat group and 30·39 months (26·87-not estimable) for the placebo group (HR 0·87, 95% CI 0·69-1·10; p=0·26). The proportion of patients achieving an overall response did not differ between treatment groups (235 [60·7%, 95% CI 55·7-65·6] for panobinostat vs 208 [54·6%, 49·4-59·7] for placebo; p=0·09); however, the proportion of patients with a complete or near complete response was significantly higher in the panobinostat group than in the placebo group (107 [27·6%, 95% CI 23·2-32·4] vs 60 [15·7%, 12·2-19·8]; p=0·00006). Minimal responses were noted in 23 (6%) patients in the panobinostat group and in 42 (11%) in the placebo group. Median duration of response (partial response or better) was 13·14 months (95% CI 11·76-14·92) in the panobinostat group and 10·87 months (9·23-11·76) in the placebo group, and median time to response (partial response or better) was 1·51 months (1·41-1·64) in the panobinostat group and 2·00 months (1·61-2·79) in the placebo group. Serious adverse events were reported in 228 (60%) of 381 patients in the panobinostat group and 157 (42%) of 377 patients in the placebo group. Common grade 3-4 laboratory abnormalities and adverse events (irrespective of association with study drug) included thrombocytopenia (256 [67%] in the panobinostat group vs 118 [31%] in the placebo group), lymphopenia (202 [53%] vs 150 [40%]), diarrhoea (97 [26%] vs 30 [8%]), asthenia or fatigue (91 [24%] vs 45 [12%]), and peripheral neuropathy (67 [18%] vs 55 [15%]). INTERPRETATION: Our results suggest that panobinostat could be a useful addition to the treatment armamentarium for patients with relapsed or relapsed and refractory multiple myeloma. Longer follow up will be necessary to determine whether there is any effect on overall survival.
    The Lancet Oncology 10/2014; 15(11):1195-206. DOI:10.1016/S1470-2045(14)70440-1 · 24.73 Impact Factor
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    ABSTRACT: Background The prognostic utility of VEGF-A splice variants in advanced breast cancer patients treated with bevacizumab (Bev) has not been studied. Patients and Methods 111 patients with metastatic breast cancer treated with weekly docetaxel or ixabepilone without bevacizumab (Cohort A) and 100 treated with weekly paclitaxel and bevacizumab (Cohort B) were studied. Formalin-fixed tumors were macrodissected for RT-qPCR relative quantification of VEGF-A165, 189, 206 isoforms spliced at exon 8 proximal site (VEGF-Axxxa) and at exon 8 distal splice site (VEGF-Axxxb). Results For high VEGF-Axxxa, the Hazard Ratio (HR) for progression was 1.08 (p=0.71) in non-Bev treated patients (Cohort A) and 0.66 (p=0.22) in Bev-treated patients (Cohort B), while the HR for death was 1.45 (p=0.13) and 0.50 (p=0.049) respectively. The interaction of VEGF-Axxxa with bevacizumab administration was significant (p=0.011) for OS. High tissue VEGF-Axxxb was not prognostic in Cohort A but was predictive for Bev benefit in Cohort B (HR for progression 0.57, p=0.04 and HR for death 0.51, p=0.02). Exploratory analyses done only in Cohort B suggested that abundance of VEGFR1 mRNA in peripheral blood and low VEGFR2 mRNA in tissue correlated with poor outcome. In multivariate analysis, high tissue mRNA of angiogenic VEGF-Axxxa in the presence of bevacizumab therapy predicted for favorable PFS (HR for progression 0.39, p=0.0227) and OS (HR for death 0.32, p=0.0140). Conclusions Tissue mRNA expression of angiogenic VEGF-Axxxa isoforms was retrospectively associated with adverse prognosis in the absence of bevacizumab and with favorable outcome when bevacizumab was administered in patients with advanced breast cancer.
    Clinical Breast Cancer 10/2014; 14(5). DOI:10.1016/j.clbc.2014.02.009 · 2.63 Impact Factor
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    ABSTRACT: Bortezomib-dexamethasone is widely used for relapsed myeloma in routine clinical practice, but comparative data versus single-agent bortezomib are lacking. This retrospective analysis compared second-line treatment with bortezomib-dexamethasone and bortezomib using 109 propensity score-matched pairs of patients treated in three clinical trials: MMY-2045, APEX, and DOXIL-MMY-3001. Propensity scores were estimated using logistic regression analyses incorporating 13 clinical variables related to drug exposure or clinical outcome. Patients received intravenous bortezomib 1.3 mg/m2 on days 1, 4, 8, and 11, in 21-day cycles, alone or with oral dexamethasone 20 mg on the days of/after bortezomib dosing. Median bortezomib cumulative dose (27.02 and 28.60 mg/m2) and treatment duration (19.6 and 17.6 weeks) were similar with bortezomib-dexamethasone and bortezomib, respectively. The overall response rate was higher (75% versus 41%, odds ratio =3.467, P<0.001), and median time-to-progression (13.6 versus 7.0 months, hazard ratio [HR]=0.394, P=0.003) and progression-free survival (11.9 versus 6.4 months, HR=0.595, P=0.051) were longer with bortezomib-dexamethasone versus bortezomib, respectively. Rates of any-grade adverse events, most common grade ≥3 adverse events, and discontinuations due to adverse events appeared similar between the groups. Two patients per group died of treatment-related adverse events. These data indicate the potential benefit of bortezomib-dexamethasone compared with single-agent bortezomib at first relapse in myeloma. The MMY-2045 (NCT00908232), APEX (NCT00048230), and DOXIL-MMY-3001 (NCT00103506) clinical trials were all registered with ClinicalTrials.gov.
    Haematologica 09/2014; DOI:10.3324/haematol.2014.112037 · 5.87 Impact Factor
  • Efstathios Kastritis, Meletios A Dimopoulos
    Leukemia and Lymphoma 09/2014; 56(3):1-5. DOI:10.3109/10428194.2014.961015 · 2.61 Impact Factor
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    ABSTRACT: The combination melphalan-prednisone-thalidomide (MPT) is considered a standard therapy for patients with myeloma who are ineligible for stem-cell transplantation. However, emerging data on the use of lenalidomide and low-dose dexamethasone warrant a prospective comparison of the two approaches.
    New England Journal of Medicine 09/2014; 371(10):906-17. DOI:10.1056/NEJMoa1402551 · 54.42 Impact Factor
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    ABSTRACT: Plasmablastic lymphoma (PBL) is a rare entity which is often causally related to infection by the Human Immunodeficiency Virus (HIV). Despite its predilection for oral cavity involvement, multiple cases of extra-oral involvement have been reported in the literature, more often among immunocompetent individuals.
    Anticancer research 09/2014; 34(9):5111-5. · 1.87 Impact Factor
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    ABSTRACT: Abstract This meta-analysis aims to examine the association between alcohol consumption and multiple myeloma (MM) risk. Eligible publications were sought in PubMed up to December 31, 2013. Separate analyses were performed by study design, gender, alcoholic beverages and levels of consumption. 16 case-control studies (3,921 cases and 19,594 controls) and 10 cohort studies (3,167 incident cases in a total cohort of 2,557,649 subjects) were eligible. Ever consumption of alcohol was associated with reduced MM risk (pooled RR=0.88, 95%CI: 0.79-0.99) and especially consumption of wine correlated with reduced MM risk (pooled RR=0.77, 95%CI: 0.67-0.89 for ever drinkers). MM risk was not affected by beer or liquor intake. A protective association was observed among females (pooled RR=0.79, 95%CI: 0.69-0.89 for ever drinkers), whereas the association among males seemed null. In conclusion, contrary to most solid tumors, alcohol intake may confer protection in terms of MM risk among females, with wine being particularly beneficial.
    Leukemia and Lymphoma 08/2014; DOI:10.3109/10428194.2014.956312 · 2.61 Impact Factor
  • Meletios A Dimopoulos, Evangelos Terpos
    Blood 08/2014; 124(8):1209-10. DOI:10.1182/blood-2014-06-579706 · 9.78 Impact Factor
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    ABSTRACT: Solitary plasmacytoma (SP) is a rare plasma cell dyscrasia characterized by the presence of bone or extramedullary plasma cell tumors. The treatment of choice is local radiotherapy (R/T) ± surgical excision. The role of adjuvant chemotherapy (C/T) or novel agents (NA) is uncertain. Data related to prognostic factors are inconclusive. Herein, we describe the clinical features, survival and prognosis of 97 consecutive patients, 65 with bone SP (SBP) and 32 with extramedullary SP (SEP), diagnosed and treated in 12 Greek Myeloma Centers. Objective response rate (≥PR) and complete response (CR) was 91.8% and 61.9%, respectively, and did not differ between the 2 groups. Overall, 38 patients relapsed or progressed to multiple myeloma (MM). After a median follow-up of 60 months, 5 and 10-year overall survival (OS) probability was 92% and 89% in SEP and 86% and 69% in SBP, respectively (p=0.2). The 5 and 10-year MM-free survival (MMFS) probability was 90% and 70% for patients with SEP vs. 59% and 50% for patients with SBP, respectively (p=0.054). Overall, the 5 and 10-year OS probability, plasmacytoma relapse-free survival (PRFS), progression-free survival and MMFS was 84% and 78%, 72% and 58%, 58% and 43% and 70% and 59%, respectively. In the multivariate analysis, prolonged PRFS and young age were positive predictors of OS. Achievement of CR was the only positive predictor of PRFS. Immunoparesis was the only negative predictor of progression to MM. The addition of C/T or NA-based treatment increased toxicity without offering any survival advantage over R/T.
    American Journal of Hematology 08/2014; 89(8). DOI:10.1002/ajh.23745 · 3.48 Impact Factor
  • Leukemia 07/2014; 28(12). DOI:10.1038/leu.2014.230 · 9.38 Impact Factor
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    ABSTRACT: Background:Melphalan is one of the most active chemotherapeutic agents in the treatment of multiple myeloma (MM). However, the mechanism underlying differential patient responses to melphalan therapy is unknown.Methods:Chromatin structure, transcriptional activity and DNA damage response signals were examined following ex vivo treatment with melphalan of both malignant bone marrow plasma cells (BMPCs) and peripheral blood mononuclear cells (PBMCs) of MM patients, responders (n=57) or non-responders (n=28) to melphalan therapy. PBMCs from healthy controls (n=25) were also included in the study.Results:In both BMPCs and PBMCs, the local chromatin looseness, transcriptional activity and repair efficiency of the transcribed strand (TS) were significantly higher in non-responders than in responders and lowest in healthy controls (all P<0.05). Moreover, we found that melphalan-induced apoptosis inversely correlated with the repair efficiency of the TS, with the duration of the inhibition of mRNA synthesis, phosphorylation of p53 at serine 15 and apoptosis rates being higher in responders than in non-responders (all P<0.001).Conclusions:Our findings provide a mechanistic basis for the link between DNA repair efficiency and response to melphalan therapy. Interestingly, the observation of these phenomena in PBMCs provides a novel approach for the prediction of response to anti-myeloma therapy.British Journal of Cancer advance online publication, 22 July 2014; doi:10.1038/bjc.2014.410 www.bjcancer.com.
    British Journal of Cancer 07/2014; 111(7). DOI:10.1038/bjc.2014.410 · 4.82 Impact Factor
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    ABSTRACT: Waldenström's macroglobulinemia (WM) is a distinct B-cell lymphoproliferative disorder for which clearly defined criteria for the diagnosis, initiation of therapy and treatment strategy have been proposed as part of the consensus panels of International Workshops on WM (IWWM). As part of the IWWM-7 and based on recently published and ongoing clinical trials the panels updated treatment recommendations. Therapeutic strategy in WM should be based on individual patient and disease characteristics (age, comorbidities, need for rapid disease control, candidacy for autologous transplantation, cytopenias, IgM-related complications (hyperviscosity, neuropathy). Mature studies show that rituximab combinations with cyclophosphamide/dexamethasone (DRC), or bendamustine (BR) or bortezomib/dexamethasone (BDR) provided durable responses and are indicated for most patients. New monoclonal antibodies (ofatumumab), second generation proteasome inhibitors (carfilzomib), mTOR inhibitors and BTK inhibitors, are promising and may expand future treatment options. A different regimen is typically recommended for relapsed or refractory disease. In selected patients with relapsed disease after long lasting remission re-use of a prior effective regimen may be appropriate. AutoSCT may be considered in young patients with chemosensitive disease and in newly diagnosed patients with very high-risk features. Active enrollment of patients with WM in clinical trials is encouraged.
    Blood 07/2014; 124(9). DOI:10.1182/blood-2014-03-565135 · 9.78 Impact Factor
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    ABSTRACT: The use of intravenous bisphosphonates (pamidronate or zoledronic acid) is the cornerstone for the management of multiple myeloma-(MM-) related bone disease. However, osteonecrosis of the jaw (ONJ) is a rare, but sometimes difficult to manage, adverse effect of bisphosphonates therapy. A retrospective review of all MM patients who were treated with bisphosphonates in our department, from 2003 to 2013, and developed ONJ was performed. According to inclusion criteria, 38 patients were studied. All these patients were treated as conservatively as possible according to the American Association of Oral and Maxillofacial Surgeons criteria. Patients were managed with observation, oral antibacterial mouth rinse with chlorhexidine, oral antibiotics, pain control with analgesics, nonsurgical sequestrectomy with or without simultaneous administration of antibiotics, or major surgery with or without antibiotics. Healing of the lesions was achieved in 23 (60%) patients who were treated with conservative measures; the median time to healing was 12 months (95% CI: 4-21). The number of bisphosphonates infusions influenced the time to healing: the median time to healing for patients who received <16 infusions was 7 months and for those with >16 infusions was it 14 months (P = 0.017). We conclude that a primarily nonsurgical approach appears to be a successful management strategy for bisphosphonate-related ONJ.
    International Journal of Dentistry 06/2014; 2014:427273. DOI:10.1155/2014/427273
  • Maria Gkotzamanidou, Evangelos Terpos, Efstathios Kastritis, Meletios Athanasios Dimopoulos
    Clinical Lymphoma, Myeloma and Leukemia 06/2014; DOI:10.1016/j.clml.2014.06.002 · 1.93 Impact Factor
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    ABSTRACT: Suppression of uninvolved immunoglobulins is common in multiple myeloma (MM) but the prognostic significance of this phenomenon has not been assessed. We evaluated the prognostic significance of the preservation of uninvolved immunoglobulins in 1755 consecutive, unselected, patients with newly diagnosed, symptomatic MM with pre-therapy immunoglobulin levels measured by nephelometry. Suppression of at least one uninvolved immunoglobulin was observed in 87% of patients and was more common in patients with IgA myeloma, those aged over 65 years, in patients with advanced ISS stage, extensive BM infiltration, anemia, low platelet counts, high levels of serum M-monoclonal protein or renal dysfunction. Patients with preserved immunoglobulins had a better survival than patients with suppressed immunoglobulins (median survival 55 vs 41.5 months, P<0.001). In multivariate analysis, preservation of uninvolved immunoglobulins was independently associated with better survival (HR:0.781, 95%CI 0.618-0.987, P=0.039); irrespective of the treatment. In a subset of 500 patients, which were strictly followed for disease progression, preservation of uninvolved immunoglobulins was associated with a significantly longer PFS (60 vs 25 months, P<0.001), independently of other common prognostic factors. In conclusion, preservation of uninvolved immunoglobulins in newly diagnosed patients with symptomatic MM was independently associated with long term disease control and improved survival.Leukemia accepted article preview online, 18 March 2014; doi:10.1038/leu.2014.110.
    Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K 03/2014; 28(10). DOI:10.1038/leu.2014.110 · 9.38 Impact Factor
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    ABSTRACT: Lenalidomide has been linked to second primary malignancies in myeloma. We aimed to pool and analyse available data to compare the incidence of second primary malignancies in patients with and without lenalidomide exposure. We identified relevant studies through a search of PubMed and abstracts from the American Society of Clinical Oncology, American Society of Hematology, and the International Myeloma Workshop. Randomised, controlled, phase 3 trials that recruited patients with newly diagnosed multiple myeloma between Jan 1, 2000, and Dec 15, 2012, and in which at least one group received lenalidomide were eligible for inclusion. We obtained individual patient data (age, sex, date of diagnosis, allocated treatment and received treatment, duration of treatment and cause of discontinuation, maintenance treatment, date of first relapse, date of second primary malignancy diagnosis, type of second primary malignancy, date of death or last contact, and cause of death) by direct collaboration with the principal investigators of eligible trials. Primary outcomes of interest were cumulative incidence of all second primary malignancies, solid second primary malignancies, and haematological second primary malignancies, and were analysed by a one-step meta-analysis. We found nine eligible trials, of which seven had available data for 3254 patients. 3218 of these patients received treatment (2620 had received lenalidomide and 598 had not), and were included in our analyses. Cumulative incidences of all second primary malignancies at 5 years were 6·9% (95% CI 5·3-8·5) in patients who received lenalidomide and 4·8% (2·0-7·6) in those who did not (hazard ratio [HR] 1·55 [95% CI 1·03-2·34]; p=0·037). Cumulative 5-year incidences of solid second primary malignancies were 3·8% (95% CI 2·7-4·9) in patients who received lenalidomide and 3·4% (1·6-5·2) in those that did not (HR 1·1 [95% CI 0·62-2·00]; p=0·72), and of haematological second primary malignancies were 3·1% (95% CI 1·9-4·3) and 1·4% (0·0-3·6), respectively (HR 3·8 [95% CI 1·15-12·62]; p=0·029). Exposure to lenalidomide plus oral melphalan significantly increased haematological second primary malignancy risk versus melphalan alone (HR 4·86 [95% CI 2·79-8·46]; p<0·0001). Exposure to lenalidomide plus cyclophosphamide (HR 1·26 [95% CI 0·30-5·38]; p=0·75) or lenalidomide plus dexamethasone (HR 0·86 [95% CI 0·33-2·24]; p=0·76) did not increase haematological second primary malignancy risk versus melphalan alone. Patients with newly diagnosed myeloma who received lenalidomide had an increased risk of developing haematological second primary malignancies, driven mainly by treatment strategies that included a combination of lenalidomide and oral melphalan. These results suggest that alternatives, such as cyclophosphamide or alkylating-free combinations, should be considered instead of oral melphalan in combination with lenalidomide for myeloma. Celgene Corporation.
    The Lancet Oncology 02/2014; 15(3). DOI:10.1016/S1470-2045(13)70609-0 · 24.73 Impact Factor
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    ABSTRACT: In this report, a panel of European myeloma experts discuss the role of pomalidomide in the treatment of relapsed and refractory multiple myeloma (RRMM). Based on the available evidence, the combination of pomalidomide and low-dose dexamethasone is a well-tolerated and effective treatment option for patients with RRMM who have exhausted treatment with lenalidomide and bortezomib. The optimal starting dose of pomalidomide is 4 mg given on days 1-21 of each 28-day cycle, while dexamethasone is administered at a dose of 40 mg weekly (reduced to 20 mg for patients aged >75 years). The treatment should continue until evidence of disease progression or unacceptable toxicity. Dose-modification schemes have been established for patients who develop neutropenia, thrombocytopenia and other grade 3-4 adverse events during pomalidomide therapy. Guidance on the prevention and management of infections and venous thromboembolism are provided, based on the available clinical evidence and the experience of panel members. The use of pomalidomide in special populations, such as patients with advanced age, renal impairment or unfavourable cytogenetic features, is also discussed.Leukemia accepted article preview online, 5 February 2014; doi:10.1038/leu.2014.60.
    Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K 02/2014; 28(8). DOI:10.1038/leu.2014.60 · 9.38 Impact Factor

Publication Stats

15k Citations
3,524.78 Total Impact Points

Institutions

  • 2000–2015
    • National and Kapodistrian University of Athens
      • Division of Clinical Therapeutics
      Athínai, Attica, Greece
    • Evangelismos Hospital
      Athínai, Attica, Greece
    • University Hospital of Ioannina
      Yannina, Epirus, Greece
  • 1996–2015
    • Alexandra Regional General Hospital
      Athínai, Attica, Greece
  • 1996–2014
    • Harokopion University of Athens
      Athínai, Attica, Greece
  • 2012
    • Università degli Studi di Torino
      Torino, Piedmont, Italy
  • 2011
    • Mediterranean Institute of Hematology
      Roma, Latium, Italy
    • James A. Haley Veterans Hospital
      Tampa, Florida, United States
  • 2010
    • Sapienza University of Rome
      Roma, Latium, Italy
  • 2009
    • University of California, San Francisco
      San Francisco, California, United States
    • Centre Hospitalier de Lens
      Lens, Nord-Pas-de-Calais, France
    • Geisinger Medical Center
      Danville, Pennsylvania, United States
  • 2006–2009
    • Attikon University Hospital
      • Department of Internal Medicine IV
      Athens, Attiki, Greece
    • Ευρωκλινική
      Athínai, Attica, Greece
  • 2003–2009
    • Harvard University
      Cambridge, Massachusetts, United States
    • National Hellenic Research Foundation
      • Institute of Biology, Medicinal Chemistry and Biotechnology
      Athínai, Attica, Greece
    • Metaxa Cancer Hospital
      Le Pirée, Attica, Greece
  • 2008
    • University of Maryland, Baltimore
      • Greenebaum Cancer Center
      Baltimore, MD, United States
  • 1997–2008
    • Κωνσταντοπούλειο νοσοκομείο Νέας Ιωνίας (Η Αγία Όλγα)
      Athínai, Attica, Greece
  • 2007
    • University of Patras
      Rhion, West Greece, Greece
  • 2006–2007
    • Yale University
      • School of Medicine
      New Haven, CT, United States
  • 2003–2007
    • University Hospital of Heraklion
      Irákleio, Attica, Greece
  • 2002–2007
    • University of Ioannina
      Yannina, Epirus, Greece
    • Hygeia Hospital
      Athínai, Attica, Greece
  • 2005
    • BMI The Alexandra Hospital
      Cheadle Hulme, England, United Kingdom
    • Henry Dunant Hospital
      Athínai, Attica, Greece
  • 2004–2005
    • Aristotle University of Thessaloniki
      • Laboratory of Ecology
      Saloníki, Central Macedonia, Greece
  • 1991–2005
    • University of Texas MD Anderson Cancer Center
      • Department of Lymphoma and Myeloma
      Houston, Texas, United States
  • 1999–2004
    • University of Houston
      Houston, Texas, United States
    • University of Crete
      • Department of Medical Oncology
      Réthymnon, Kriti, Greece
  • 2000–2003
    • Hellenic Cooperative Oncology Group
      Athínai, Attica, Greece
  • 1994
    • Royal Melbourne Hospital
      Melbourne, Victoria, Australia
  • 1989–1991
    • Laiko Hospital
      Athínai, Attica, Greece
  • 1990
    • General Hospital of Komotini "Sismanoglio"
      Komotina, East Macedonia and Thrace, Greece