Journal: Leukemia & lymphoma
This meta-analysis of randomized studies up to February 2025 evaluated first-line treatment strategies in newly diagnosed multiple myeloma patients ineligible for autologous transplantation.
Key findings include:
- Modern triplet and quadruplet regimens significantly reduce the risk of progression or death (HR 0.63).
- They also substantially increase MRD negativity rates (OR 3.15), with good tolerability.
- Quadruplet regimens are recommended for fit patients.
- Triplet regimens are advised for patients with intermediate fitness.
- Dexamethasone-sparing approaches are preferred for frail individuals.
The study emphasizes the importance of frailty assessment to guide personalized therapy in this population.