A recent report published in Blood journal monitored the effects of Revlimid (lenalidomide) and dexamethasone (Decadron) on patients with relapsed or refractory myeloma who exhibited cytogenetic, or chromosomal, abnormalities.

A cytogenetic abnormality is a difference in either the number or structure of a person’s chromosomes, which carry DNA. The researchers in this study focused on three common cytogenetic abnormalities that occur in myeloma patients: del(13q), del(17p13) and t(4;14).

Del(13q) refers to a deletion of a large section, or “arm,” of chromosome 13, while del(17p13) refers to the deletion of a small area on chromosome 17. The third abnormality, t(4;14), indicates a translocation. Translocations are the exchange of genetic material between two unrelated chromosomes; in t(4;14) cases, the translocation occurs between chromosomes 4 and 14.

This study aimed to determine whether Revlimid and dexamethasone, both effective treatments for patients with relapsed or refractory myeloma, would have any influence on those with chromosomal abnormalities.

Researchers evaluated 130 participants from a larger study who exhibited one of the three chromosomal aberrations.

The study measured each participant’s time to progression and overall survival. Time to progression is the amount of time it takes for a disease to worsen following diagnosis or start of treatment, and overall survival is the percentage of patients who survive after a designated period of time. In this study, the median follow-up time on which overall survival data is based was 19.7 months.

According to the report, patients with del(13q) or t(4;14) had a median time to progression (5.9 months and 8 months, respectively) and overall survival (14.7 months and 23.7 months, respectively) comparable to those without chromosomal abnormalities. However, those with del(17p13) had significantly shorter survival times. Their median time to progression was 2.2 months and median overall survival was 4.7 months.

The researchers concluded that Revlimid plus dexamethasone is an effective treatment for relapsed or refractory myeloma patients, and induces durable response in patients with relapsed t(4;14) and del(13q) myeloma, though it is not effective for those with del(17p13). They stated that there is a need for novel therapeutic approaches to treat those with this chromosomal abnormality.

For more information, visit the Blood journal article (article abstract viewable for free; full article available for a fee) or the Myeloma Beacon articles on risk stratiication according to Leukemia journal and the International Myeloma Workshop (IMW), which provide additional information on cytogenetic abnormalities.