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Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.

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Low-Dose Revlimid Maintenance Post Autologous Stem Cell Transplant- Pros/Cons

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“Serious adverse events were reported in 494 (45%) of 1097 patients receiving lenalidomide compared with 150 (17%) of 874 patients on observation…”

Hello David- I posted a comment a few months ago. My multiple myeloma diagnosis led to an ASCT and low-dose Revlimid maintenance therapy (LDRMT) since June 2019 although my doctor told me I am in complete remission since april of same year.

After the usual Bortezomib -cortizone- preparation therapy once a week for 4 months, I underwent a heavy Melphalan autologous cell transplant…which got rid of all remaining cancer

My wife and I are pronatural,…organic…glutenfree etc advocates.

Some people say  that Revlimid is useless since I already am in total …remission.
As you also know, doctors and pharmacists alike say that antioxydants are a no go when undergoing anti cancer conventional therapies..

Thank you for your input regarding the latests remarks. Regards, Matt


Hi Matt-

Thanks for reaching out. Your situation helps me illustrate the pros and cons of low-dose revlimid maintenance therapy (LDMRT) post ASCT.

Congratulations on reaching complete remission following your RVD induction therapy and autologous stem cell transplant.

Because your comments didn’t stipulate if you are high risk or not, I included both in the research excerpted below.

I chose the study below because:

  1. it is relevant (induction triplets are different from you but the ASCT is melphalan  based)
  2. it is current (published 12/2018)
  3. the research seems to apply directly to your situation- induction, ASCT, low-dose revlimid maintenance therapy-

As I see them, the pros and cons of low-dose revlimid maintenance are:

  • LDMRT provides superior progression-free survival (time of first remission) compared to observation-
  • LDMRT provides similar overall survival (length of life) in the study below but I’m pretty sure that other studies document a longer average OS for LDMRT-
  • LDMRT does result in a much greater risk of serious adverse events aka side effects. More chemotherapy means more toxicity which results in more damage to the patient.

It is the increased risk of side effects that have always been my problem with conventional MM chemotherapy. For the record, the study below doesn’t just document side effects, it documents serious grade 3 and 4 adverse events.

Grade 3 and 4 side effects are serious health problems. Secondary cancers, myelosuppression,  even death.

It is the greater risk of serious side effects that cause me to encourage LDMRT but try to reduce toxicity in any way possible including:

  • speak to your oncologist about lowering the dose of revlimid- 
  • add evidence-based, integrative therapies shown to enhance the efficacy of revlimid while reducing toxicity
  • add evidence-based complimentary therapies such as exercise, detox., anti-angiogenic nutrition/supplementation, etc. 

The solution Matt, for me at least, has always been to take the best of both conventional MM therapy and combine it with evidence-based, non-conventional therapies.

Keep in touch and let me know how your MM therapies progress.


David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Lenalidomide maintenance versus observation for patients with newly diagnosed multiple myeloma (Myeloma XI): a multicentre, open-label, randomised, phase 3 trial

“Patients with multiple myeloma treated with lenalidomide maintenance therapy have improved progression-free survival, primarily following autologous stem-cell transplantation.

A beneficial effect of lenalidomide maintenance therapy on overall survival in this setting has been inconsistent between individual studies.

Minimal data are available on the effect of maintenance lenalidomide in more aggressive disease states, such as patients with cytogenetic high-risk disease or patients ineligible for transplantation.

We aimed to assess lenalidomide maintenance versus observation in patients with newly diagnosed multiple myeloma, including cytogenetic risk and transplantation status subgroup analyses…

After a median follow-up of 31 months, median progression-free survival was

  • 39 months with lenalidomide and
  • 20 months (18–22) with observation,

and 3-year overall survival was

  • 78·6% in the lenalidomide group and
  • 75·8% in the observation group.

Progression-free survival was improved with lenalidomide compared with observation across all prespecified subgroups.

By cytogenetic risk group, in standard-risk patients,

  • 3-year overall survival was 86·4% in the lenalidomide group compared with
  • 81·3% in the observation group,

and in high-risk patients, it was

  • 74.9% in the lenalidomide group compared with
  • 63·7% in the observation group;

and in ultra-high-risk patients it was

  • 62·9%  compared with
  • 43·5%.

Since these subgroup analyses results were not powered they should be interpreted with caution.

The most common grade 3 or 4 adverse events for patients taking lenalidomide were haematological, including

  • neutropenia,
  • thrombocytopenia, and
  • anaemia.

Serious adverse events were reported in 494 (45%) of 1097 patients receiving lenalidomide compared with 150 (17%) of 874 patients on observation…”




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