Natural history of relapsed myeloma, refractory to immunomodulatory drugs and proteasome inhibitors: a multicenter IMWG study

Research output: Contribution to journalArticle


Introduction of new myeloma therapies offers new options for patients refractory to immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs). In this multicenter study, patients with relapsed multiple myeloma, who have received at least three prior lines of therapy, are refractory to both an IMiD (lenalidomide or pomalidomide) and a PI (bortezomib or carfilzomib), and have been exposed to an alkylating agent were identified. The time patients met the above criteria was defined as time zero (T0). Five hundred and forty-three patients diagnosed between 2006 and 2014 were enrolled in this study. Median age at T0 was 62 years (range 31-87); 61% were males. The median duration between diagnosis and T0 was 3.1 years. The median number of lines of therapy before T0 was 4 (range 3-13). The median overall survival (OS) from T0 for the entire cohort was 13 (95% confidence interval (CI) 11, 15) months. At least one regimen recorded after T0 in 462 (85%) patients, with a median (95% CI) progression-free survival and OS from T0 of 5 (4, 6), and 15.2 (13, 17) months, respectively. The study provides the expected outcome of relapsed multiple myeloma that is refractory to a PI and an IMiD, a benchmark for comparison of new therapies being evaluated.Leukemia advance online publication, 16 June 2017; doi:10.1038/leu.2017.138.


  • M. A. Dimopoulos
  • E Kastritis
  • E Terpos
  • H Nahi
  • H. Goldschmidt
  • J Hillengass
  • X Leleu
  • Meral Beksac
  • M Alsina
  • Albert Oriol
  • M. Cavo
  • E. M. Ocio
  • M. V. Mateos
  • E K O'Donnell
  • R Vij
  • Henk M Lokhorst
  • Niels W C J van de Donk
  • J. Cam-min
  • Torrance Mark
  • S. Jagannath
  • M Delforge
  • Charalampia Kyriakou
  • P Hari
  • U. H. Mellqvist
  • S Z Usmani
  • D Dytfeld
  • Ashraf Z Badros
  • P R Otero
  • C Shustik
  • D Waller
  • W-J Chng
  • Shoichi Ozaki
  • Javier de la Rubia
  • H S Eom
  • L Rosinol
  • J. J. Lahuerta
  • A Sureda
  • J. S. Kim
  • B. G. M. Durie
External organisations
  • National and Kapodistrian University of Athens
  • Karolinska University Hospital
  • University Hospital Heidelberg
  • Ankara University School of Medicine
  • Skåne University Hospital
  • University of Bologna
  • University Hospital of Salamanca
  • Massachusetts General Hospital
  • Washington University School of Medicine
  • VU University Medical Center
  • Catholic University of Korea
  • Weill Cornell Medical College
  • Icahn School of Medicine at Mount Sinai
  • Belgian Hematological Society
  • Northwick Park Hospital
  • Medical College of Wisconsin
  • Sahlgrenska University Hospital
  • Carolinas HealthCare System
  • Poznan University of Medical Sciences
  • University of Maryland School of Medicine
  • University Clinic of Navarra
  • McGill University Health Center
  • McGill University
  • National University Health System
  • Tokushima Prefectural Central Hospital
  • Hospital Universitario Doctor Peset
  • National Cancer Center, Gyeonggi
  • Hospital Clínic of Barcelona
  • 12 de Octubre University Hospital
  • Hospital Duran i Reynals
  • Severance Hospital
  • Cedars-Sinai Medical Center
  • Poitiers University Hospital
  • H. Lee Moffitt Cancer Center & Research Institute
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology


  • Journal Article
Original languageEnglish
Pages (from-to)2443-2448
Early online date2017 May 12
Publication statusPublished - 2017
Publication categoryResearch