title: Efficacy of dose-reduced lenalidomide in patients with refractory or recurrent multiple myeloma.
abstract: OBJECTIVE
  Introduction of lenalidomide has expanded the therapeutic options for refractory and recurrent multiple myeloma (MM) patients. However, the application of the approved doses may be difficult in some patients due to adverse effects.
  
  
  METHODS
  Therefore, we evaluated the efficacy and safety of lenalidomide in 10 patients with relapsed and refractory MM who received a reduced dose due to leukopenia (4), polyneuropathy (1), muscle cramps (1), thrombocytopenia (1), renal insufficiency (1), at the request of patient (1), as continuous therapy (1), either from the beginning (2) or during treatment (8). They received lenalidomide at a mean (median) daily dose of 14 (15) mg/d once a day (days 1-21 every 28 days) in combination with dexamethasone at a mean (median) dose of 17.6 (28) mg per day (4-40 mg) on days 1-4, 9-12 and 17-20.
  
  
  RESULTS
  Mean (median) duration of treatment with lenalidomide was 15.1 (15) months. Partial response or better was reported in seven and minimal response or better was reported in eight patients. Mean (median) values for time-to-progression (TTP) and for progression-free survival (PFS) were 8.7 (4) months. Mean overall survival (OS) has not been reached, all patients are still alive.
  
  
  CONCLUSIONS
  In conclusion, dose-reduced lenalidomide is an effective and well tolerated treatment for patients with recurrent or refractory MM who cannot tolerate full doses.
authors.affiliation: Department of Internal Medicine III, Center for Integrated Oncology (CIO), Universitätsklinikum Bonn, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schwamborn
authors.forename: Marcus
authors.initials: M
authors.lastname: Gorschlüter
authors.forename: Axel
authors.initials: A
authors.lastname: Glasmacher
authors.forename: Ingo G H
authors.initials: IG
authors.lastname: Schmidt-Wolf
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide