Primera experiencia sobre efectividad y seguridad de lenalidomida-bortezo-mib-dexametasona (RVd) como tratamiento de inducción en pacientes con diagnóstico reciente de mieloma múltiple (MM) candidatos a trasplante hematopoyético en Argentina. Estudio colaborativo del Grupo Argentino de Mieloma Múltiple (GAMM)

Introduction: the objective of first-line treatment in patients with MM who are candidates for autologous hematopoietic transplantation (HSCT) is to achieve the greatest possible depth of response, which has prolonged survival in this group of patients (pts). Different induction schemes are available prior to HSCT. Currently, the RVd scheme one of the best recommended options according to different treat-ment guidelines. There are no published data on the efficacy and safety of RVd as an induction regimen in Latin America in real word evidence studies.Objectives: our primary objective was to describe the efficacy of RVd as induction prior to HSCT. In addition, treatment-related toxicities, progres-sion-free survival (PFS), and overall survival (OS) were evaluated.Material and methods: retrospective, multicenter study of 13 centers belonging to the GAMM. Adult pts with newly diagnosed MM candidates for HSCT treated with RVd between April 2016 and April 2021 were included. Response rates were analyzed according to IMWG-2016 criteria and toxicities ac-cording to CTCAE V4.3.Results: 110 pts with a median age of 58 years (range 29-71) with 50% female subjects and a median follow-up of 17 months were included. 29 pts (27%) presented R-ISS 3, 21 pts (19%) high cytoge-netic risk and 11 pts (10%) extramedullary disease. The median number of RVd cycles received was 6 (range 2-10). 15 pts (14%) required plerixafor prior to stem cell collection and 14 pts (13%) failed ini-tial mobilization. The median number of CD34+ cells per kg was 4.6 x 106 (IQR 3.21-6.14). Response rates prior to HSCT were: 97% overall response rate (ORR), 77% very good partial response (VGPR) or greater and 40% complete response (CR). The CR rate was similar between patients with high cyto-genetic risk vs. standard risk (p:0.39). Post-HSCT response rates were: 99% ORR, 93% VGPR or great-er and 75% CR. The most frequent adverse events of any grade were: hematological (42%), infectious (39%), gastrointestinal (29%) and peripheral neuropathy (23%). The PFS at 24 months was 88% for the entire cohort (95% CI 75-94). In those pts who achieved CR prior to HSCT, the PFS at 24 months was 100% vs 80% in the rest (p: 0.005). The OS at 24 months is 95% (95% CI 87-98).Conclusions: in our cohort outside of a clinical trial, RVd turned out to be an effective regimen with an adequate safety profile. The HSCT further deep-ened response rates. This is the first experience of the use of RVd as induction prior to HS