title: Very low-dose lenalidomide therapy for elderly multiple myeloma patients.
abstract: Lenalidomide treatment for refractory or relapsed multiple myeloma in elderly patients may be feasible in an outpatient setting. However, difficulties have been associated with the management of adverse effects. Therefore, a dose reduction in lenalidomide has been recommended in some cases. In this report, we encountered the successful treatment of myeloma in 6 elderly patients (aged above 70 years) with very low-dose lenalidomide (5 mg daily). Four patients exhibited more than a partial response with an 8.6 months median follow-up period, which was comparable with previous findings. The major adverse effect observed was infection, which occurred during the first several cycles. Others were less toxic, especially the absence of grade 3/4 toxicities for hematological adverse effects.Although a dose reduction in lenalidomide therapy for elderly patients is controversial, a very low dose could be safe and effective. Our group is currently conducting a multi-center prospective trial to evaluate the efficacy of low-dose lenalidomide therapy.
authors.affiliation: Hematology, Department of Medicine, Kobe University Graduate School of Medicine.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Minagawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawano
authors.forename: Takuma
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Inagaki
authors.forename: Minoru
authors.initials: M
authors.lastname: Kishi
authors.forename: Tamaki
authors.initials: T
authors.lastname: Hirata
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kimura
authors.forename: Miho
authors.initials: M
authors.lastname: Takechi
authors.forename: Toru
authors.initials: T
authors.lastname: Koide
authors.forename: Masahide
authors.initials: M
authors.lastname: Iwai
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Katayama
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Matsui
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007155:Immunologic Factors; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide