Guidelines for counting lines of therapy in myeloma
| Definition of a new line of therapy . | Comment . |
|---|---|
| Discontinuation of 1 treatment regimen and start of another* | The reasons for discontinuation, addition, substitution, or SCT do not influence how lines are counted. It is recognized that reasons for change may include end of planned therapy, toxicity, progression, lack of response, inadequate response, etc. |
| Unplanned addition or substitution of 1 or more drugs in a regimen | |
| In patients undergoing >1 SCT, each SCT (autologous or allogeneic) is considered a new line of therapy | Note that a planned tandem SCT is an exception and is considered 1 line. Planned induction and/or consolidation, maintenance with any SCT (frontline, relapse, autologous or allogeneic) is considered 1 line. |
| Definition of a new line of therapy . | Comment . |
|---|---|
| Discontinuation of 1 treatment regimen and start of another* | The reasons for discontinuation, addition, substitution, or SCT do not influence how lines are counted. It is recognized that reasons for change may include end of planned therapy, toxicity, progression, lack of response, inadequate response, etc. |
| Unplanned addition or substitution of 1 or more drugs in a regimen | |
| In patients undergoing >1 SCT, each SCT (autologous or allogeneic) is considered a new line of therapy | Note that a planned tandem SCT is an exception and is considered 1 line. Planned induction and/or consolidation, maintenance with any SCT (frontline, relapse, autologous or allogeneic) is considered 1 line. |
A discontinued regimen restarted at a later date will be counted as a new line of therapy if there were 1 or more other regimens administered in between. Restarting the same regimen (even with dose modifications) without any other intervening regimen is not considered a new line.