Long-term health-related quality of life in transplant-ineligible patients with newly diagnosed multiple myeloma receiving lenalidomide and dexamethasone

Leuk Lymphoma. 2018 Feb;59(2):398-405. doi: 10.1080/10428194.2017.1334125. Epub 2017 Jun 22.


The FIRST trial demonstrated that continuous therapy with lenalidomide and dexamethasone (Rd) prolongs overall survival (OS) and improves health-related quality of life (HRQoL) during the first 18 months of therapy in newly diagnosed multiple myeloma (NDMM) patients. However, patient-reported HRQoL data were not collected after 18 months. We therefore estimated HRQoL scores based on time-varying data collected during progression-free follow-up after 18 months. During the initial 18 months of Rd, observed changes from baseline were within the 95% confidence interval of the predictive models at 33 of 35 time points across 7 HRQoL scores. Predicted scores after 18 months of therapy showed that observed HRQoL improvements during therapy were maintained or improved. Therefore, the survival gain observed with Rd does not come at a cost of declining HRQoL during continuous therapy beyond 18 months, supporting long-term Rd as a standard of care for initial myeloma therapy.

Keywords: FIRST trial; Quality of life; dexamethasone; lenalidomide; newly diagnosed multiple myeloma.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Dexamethasone
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Intention to Treat Analysis
  • Lenalidomide
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / therapy
  • Quality of Life*
  • Reproducibility of Results
  • Thalidomide / analogs & derivatives
  • Time Factors
  • Treatment Outcome


  • Thalidomide
  • Dexamethasone
  • Lenalidomide