2011, Number 2
<< Back Next >>
Rev Hematol Mex 2011; 12 (2)
Lenalidomide maintains remissions in persons with multiple myeloma intolerant to thalidomide
Ruiz-Delgado GJ, Ruiz-Argüelles GJ
Language: English
References: 10
Page: 79-81
PDF size: 62.61 Kb.
ABSTRACT
Background: The most recommended therapy-approach in patients with multiple (MM) myeloma in México is induction with thalidomide and dexametasone (Thal/Dex) followed by autologous hematopoietic stem cell transplantation, followed by Thal maintenance; however, the toxicity of Thal develops eventually in most patients with MM. Lenalidomide (Len) is an expensive drug.
Material and methods: In a single institution in México, patients with MM intolerant to Thal were switched to Len during maintenance therapy. Eight of twelve subjects with MM who were able to defray the cost of Len were switched from Thal to Len as remission maintenance after developing peripheral neuropathy.
Results: Amount of monoclonal protein when Len was started dropped or remained stable. One subject had amyloidosis-related nephrotic syndrome; the amount of urinary albumin dropped following Len therapy. Side-effects of Thal remained stable or improved, as judged subjectively by the patients.
Conclusions: A delay in the introduction of Len in the treatment of patients with MM results in lower costs.
REFERENCES
Ruiz-Argüelles GJ, Gómez-Rangel D, Ruiz-Delgado GJ, Aguilar-Romero L. Multiple myeloma in México: A single institution, twenty-year experience. Arch Med Res 2004;35: 163-167.
Richardson P, Jagannath S, Hussein M, et al. Safety and efficacy of single agent lenalidomide in patients with relapsed and refractory multiple myeloma. Blood 2009;114:772-778.
Kumar SK, Rajkumar SV, Dispenzieri A, et al. Improved survival in multiple mieloma and the impact of novel therapies. Blood 2008;111:2516-2520.
Weber DM, Chen C, Niesvisky R, et al. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med 2007;357:2133-2142.
Dimopoulos M, Spencer A, Attal M, et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med 2007;357:2123-2132.
Ruiz-Arguelles GJ. Whither the bone marrow transplant. Hematology 2010; 15:1-3.
Gómez-Almaguer D, Cano-Castellanos R, Cedillo-de la Cerda JL, Garcés-Ruíz O, Limón-Flores A, et al. Guías mexicanas de diagnóstico y recomendaciones terapéuticas para mieloma múltiple (2009). Rev Hematol Mex 2010;11:40-62.
López-Otero A, Ruiz-Delgado GJ, Ruiz-Argüelles GJ. A simplified method for stem cell autografting in multiple myeloma: A single institution experience. Bone Marrow Transplant 2009;44:715-719.
Zonder JA, Crowley J, Hussein MA, Bolejack V, More DF, et al. Lenalidomide and high-dose dexamethasone compared with dexamethasone as initial therapy for multiple myeloma: a randomized Southwest Oncology Group trial (S0232). Blood 2010, Sep 27. [Epub ahead of print]
Kumar S. Multiple myeloma - current issues and controversies. Cancer Treat Rev 2010;36(Suppl 2):S3-11.
Full text