Lenalidomide-induced myelosuppression is associated with renal dysfunction: adverse events evaluation of treatment-naïve patients undergoing front-line lenalidomide and dexamethasone therapy.
Data on 72 patients receiving lenalidomide/dexamethasone for multiple myeloma (MM) was used to determine the factors that are associated with lenalidomide-induced myelosuppression. Eight of 14 patients with grade > or =3 myelosuppression had baseline creatinine clearance (CrCl) < or =0.67 ml/s. Kaplan-Meier analysis by log-rank test demonstrated a significant association (P < 0.0001) between renal insufficiency and time to myelosuppression (hazard ratio = 8.4; 95% confidence interval 2.9-24.7, P = 0.0001). Therefore, CrCl is inversely associated with significant myelosuppression. Caution should be exercised when lenalidomide therapy is commenced and CrCl should be incorporated as a determinant of the initial dosing of lenalidomide in MM patients.
Niesvizky
Ruben
R
Center of Excellence for Lymphoma and Myeloma, Division of Hematology and Medical Oncology, Weill Medical College of Cornell University, New York Presbytarian Hospital-Cornell Medical Center, New York, NY 10021, USA. run9001@med.cornell.edu
Naib
Tara
T
Christos
Paul J
PJ
Jayabalan
David
D
Furst
Jessica R
JR
Jalbrzikowski
Jessica
J
Zafar
Faiza
F
Mark
Tomer
T
Lent
Richard
R
Pearse
Roger N
RN
Ely
Scott
S
Leonard
John P
JP
Mazumdar
Madhu
M
Chen-Kiang
Selina
S
Coleman
Morton
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003404:Creatinine / Q000493:pharmacokinetics; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced*; D051437:Renal Insufficiency / Q000150:complications*; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013921:Thrombocytopenia / Q000139:chemically induced*; D016896:Treatment Outcome
D013792:Thalidomide; D003907:Dexamethasone; D003404:Creatinine; D000077269:Lenalidomide