Lower Dexamethasone Dose in Multiple Myeloma: A Multicenter Retrospective Analysis
10 affiliations
- 1Department of Internal Medicine and Haematology, Semmelweis University, 1085 Budapest, Hungary
- 2Department of Hematology and Stem Cell Transplantation, South Pest Central Hospital, National Institute for Hematology and Infectious Diseases, 1097 Budapest, Hungary
- 3Somogy County Kaposi Mór Teaching Hospital, 7400 Kaposvár, Hungary
- 4Hematology, Veszprém-Csolnoky Ferenc County Hospital, 8200 Veszprém, Hungary
- 5Markusovszky University Teaching Hospital, 9700 Szombathely, Hungary
- 6Borsod-Abaúj-Zemplén Central County University Teaching Hospital, 3526 Miskolc, Hungary
- 7National Institute of Oncology, 1122 Budapest, Hungary
- 81st Department of Internal Medicine, University of Pécs, 7624 Pécs, Hungary
- 92nd Department of Medicine and Cardiology Center, University of Szeged, 6720 Szeged, Hungary
- 10Department of Hematology, Institute for Medicine, Clinical Center, University of Debrecen, 4032 Debrecen, Hungary
Abstract
Background/Objectives: Dexamethasone has long served as the cornerstone of therapy for multiple myeloma; however, its optimal dosing remains ill-defined, particularly when balanced against its profound toxicity profile. Recent therapeutic advances have consequently intensified interest in steroid dose-reduction strategies. This retrospective, multicenter study aimed to evaluate the impact of varied dexamethasone dosing regimens on clinical outcomes within a real-world setting. Methods: We conducted a retrospective multicenter study across 11 Hungarian centers, enrolling 272 patients with multiple myeloma who received lenalidomide–dexamethasone therapy. Treating physicians determined dosing strategies at their discretion for each patient. We retrospectively stratified patients into three cohorts based on their prescribed weekly dexamethasone dose: 40 mg, 20 mg, and less than 20 mg. Results: We observed a distinct interaction between patient age and weekly dexamethasone dose. Nonetheless, we detected no statistically significant difference in progression-free survival (PFS) among the three dosing cohorts (p = 0.632). Similarly, dexamethasone dose intensity demonstrated no significant association with overall treatment response (p = 0.560). Subgroup analysis restricted to patients with high-risk cytogenetics also showed no significant disparities in PFS (p = 0.312). Furthermore, early treatment response rates at 2 and 6 months were also independent of the dexamethasone dose. Notably, grade 3–5 adverse events were numerically more frequent in the 40 mg group. The lack of significant differences in these outcome measures is particularly important, given the baseline age imbalances among the cohorts. Conclusions: Lower initial dexamethasone dose was not associated with statistically significant differences in progression-free survival or treatment response in this retrospective cohort. Although Grade 3–5 adverse events were numerically more frequent in the 40 mg group, these observations warrant further investigation in prospective studies.
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BibTeX
@article{korpas2026lower,
title = {{Lower Dexamethasone Dose in Multiple Myeloma: A Multicenter Retrospective Analysis}},
author = {Lili Korpás and Ádám Wiedemann and Fruzsina Szél and Szabolcs Svorenj and Júlia Weisinger and Zsolt Nagy and Zsuzsanna Szemlaky and Zoltán Csukly and Péter Reményi and Péter Rajnics and Elvira Altai and Márk Plander and Krisztina Kórád and Erika Szaleczky and András Masszi and Szabolcs Kosztolányi and Hussain Alizadeh and Szabolcs Modok and Zita Borbényi and Szilvia Lovas and László Váróczy and Tamás Masszi and Gábor Mikala and Gergely Varga},
journal = {Cancers},
year = {2026},
month = nov,
doi = {10.3390/cancers18213565},
url = {https://www.mdpi.com/2072-6694/18/21/3565},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Lower Dexamethasone Dose in Multiple Myeloma: A Multicenter Retrospective Analysis
AU - Lili Korpás
AU - Ádám Wiedemann
AU - Fruzsina Szél
AU - Szabolcs Svorenj
AU - Júlia Weisinger
AU - Zsolt Nagy
AU - Zsuzsanna Szemlaky
AU - Zoltán Csukly
AU - Péter Reményi
AU - Péter Rajnics
AU - Elvira Altai
AU - Márk Plander
AU - Krisztina Kórád
AU - Erika Szaleczky
AU - András Masszi
AU - Szabolcs Kosztolányi
AU - Hussain Alizadeh
AU - Szabolcs Modok
AU - Zita Borbényi
AU - Szilvia Lovas
AU - László Váróczy
AU - Tamás Masszi
AU - Gábor Mikala
AU - Gergely Varga
PY - 2026
DA - 2026/11/06
JO - Cancers
DO - 10.3390/cancers18213565
UR - https://www.mdpi.com/2072-6694/18/21/3565
AB - Background/Objectives: Dexamethasone has long served as the cornerstone of therapy for multiple myeloma; however, its optimal dosing remains ill-defined, particularly when balanced against its profound toxicity profile. Recent therapeutic advances have consequently intensified interest in steroid dose-reduction strategies. This retrospective, multicenter study aimed to evaluate the impact of varied dexamethasone dosing regimens on clinical outcomes within a real-world setting. Methods: We conducted a retrospective multicenter study across 11 Hungarian centers, enrolling 272 patients with multiple myeloma who received lenalidomide–dexamethasone therapy. Treating physicians determined dosing strategies at their discretion for each patient. We retrospectively stratified patients into three cohorts based on their prescribed weekly dexamethasone dose: 40 mg, 20 mg, and less than 20 mg. Results: We observed a distinct interaction between patient age and weekly dexamethasone dose. Nonetheless, we detected no statistically significant difference in progression-free survival (PFS) among the three dosing cohorts (p = 0.632). Similarly, dexamethasone dose intensity demonstrated no significant association with overall treatment response (p = 0.560). Subgroup analysis restricted to patients with high-risk cytogenetics also showed no significant disparities in PFS (p = 0.312). Furthermore, early treatment response rates at 2 and 6 months were also independent of the dexamethasone dose. Notably, grade 3–5 adverse events were numerically more frequent in the 40 mg group. The lack of significant differences in these outcome measures is particularly important, given the baseline age imbalances among the cohorts. Conclusions: Lower initial dexamethasone dose was not associated with statistically significant differences in progression-free survival or treatment response in this retrospective cohort. Although Grade 3–5 adverse events were numerically more frequent in the 40 mg group, these observations warrant further investigation in prospective studies.
SN - 2072-6694
ER -