Continuous Lenalidomide and Low-Dose Dexamethasone for the Treatment of Patients with Newly Diagnosed Multiple Myeloma and Renal Impairment in the First Trial

Background: Second ASCT (ASCT2) is a safe and feasible for relapsed MM patients (pts), who have had durable remission from first ASCT (ASCT1). Long term stability of cryopreserved stem cells (SCs) has become an important issue in pts who require ASCT2 after a long period of disease remission. Our study aims to evaluate the engraftment ability of long term cryopreserved SCs for salvage ASCTs in a larger number of pts. Patients /Methods: We retrospectively reviewed 102 relapsed MM pts who underwent salvage ASCT2 using SCs from first collection at our institution between January 2003 to June 2013. Patient demographics, disease characteristics, chemotherapy and ASCT details were obtained from medical charts and transplant database. Neutrophil engraftment was defined as the first of 3 consecutive days that neutrophil counts were u003e0.5x109/L. Platelet engraftment was defined as day of platelet counts u003e20x109/L without supportive transfusion. Paired simple T-test was used to compare time to engraftment between ASCTs. Results: One hundred and two pts (65 males, 64%) underwent salvage ASCT for relapsed MM. Median age at diagnosis, ASCT1 and ASCT2 were 56, 57 and 61 years, respectively. Majority (98%) of pts received high dose cyclophosphamide followed by G-CSF for SCs mobilization and melphalan 200 mg/m2 for conditioning. All collected SCs were cryopreserved in 10%DMSO. Median SCs storage times were 1.9 (0.4-24.7) and 47.2 (15-131) months for ASCT1 and ASCT2, respectively. Median time duration between two ASCTs was 45 (14-128) months. Median numbers of CD34+ cells infused at ASCT1 were 6.43x106/kg (2.6-33.2) and 5.7x106/ kg (1.2-16.9) at ASCT2. There was no significant difference in median time to engraftment between ASCT1 and ASCT2; 12 (616) vs 11 (10-15) days for neutrophil engraftment (p1⁄40.33) and 11 (10-20) vs 11 (10-20) days for platelet engraftment (p1⁄40.26). There was no delayed engraftment (u003e21days) in any pts. We further investigated the stability of SCs based on years of cryopreservation at ASCT2. There was no difference in time to neutrophil (p1⁄40.06) and platelet engraftment (p1⁄40.74) between pts who were given short ( 6years) term cryopreserved SCs. Conclusion: Long term cryopreserved SCs can be safely used in salvage ASCT in relapsed MM pts. Cryopreservation of SCs u003e6 years results in no loss of viability as determined by comparable times to engraftment in both upfront and salvage ASCTs. PO-105 Continuous Lenalidomide and Low-Dose Dexamethasone for the Treatment of Patients with Newly Diagnosed Multiple Myeloma and Renal Impairment in the First Trial M. Dimopoulos, M. Cheung, M. Roussel, T. Liu, B. Gamberi, B. Kolb, H.G. Derigs, H. Eom, K. Belhadj, P. Lenain, R. van der Jagt, S. Rigaudeau, R. Hall, A. Jaccard, A. Tosikyan, L. Karlin, W. Bensinger, R. Schots, G. Chen, J. Marek, A. Ervin-Haynes, T. Facon National and Kapodistrian University of Athens, Athens, Greece; Odette Cancer Centre, Toronto, Canada; CHU Purpan/IUCT Oncopole, Toulouse, France; West China Hospital of Sichuan University, Chengdu, China, China; Arcispedale S. Maria Nuova, Reggio Emilia, Italy; Hopital Robert Debre, Paris, France; Staedtische Kliniken Frankfurt am Main Hochst, Frankfurt, Germany; National Cancer Center, Goyang, Korea, Republic Of; Hopital Henri Mondor, Creteil; Centre Henri Becquerel, Rouen, France; Ottawa Hospital, Ottawa, Canada; Hopital de Versailles, Le Chesnay, France; Royal Bournemouth Hospital, Dorset, United Kingdom; CH Hopital Dupuytren, Draveil, France; Hopital du Sacre-Coeoeoeur de Montreal, Montreal, Canada; Centre Hospitalier Lyon Sud, Pierre-Benite, France; Fred Hutchinson Cancer Center, Seattle, United States; University Hospital VUBeMyeloma Center Brussels, Brussels, Belgium; Celgene Corporation, Summit, United States; Service des Maladies du Sang, Hopital Claude Huriez, Lille, France