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Patient outcome in myeloma is improved by autologous stem cell transplantation (ASCT) consolidation following initial induction therapy. To assess the benefit of ASCT in the present era of more active induction regimens, investigators in Italy and Israel conducted an industry-supported, phase III, randomized, open-label trial comparing ASCT versus chemotherapy consolidation alone.
Patients 65 years old or younger with newly diagnosed myeloma received induction therapy with lenalidomide plus dexamethasone. Responders were randomized to tandem high-dose melphalan plus ASCT or six cycles of melphalan, prednisone, and lenalidomide (MPR). Patients in each study arm with ongoing response were randomized to lenalidomide maintenance therapy versus n…