title: Autoimmune diseases during treatment with immunomodulatory drugs in multiple myeloma: selective occurrence after lenalidomide.
abstract: Immunomodulatory drugs (IMiDs) may favor autoimmune disease (AD) occurrence. We conducted a retrospective study to evaluate AD occurrence among IMiD-treated patients with myeloma. Patients were grouped into three classes depending on the type of IMiD engaged. The first group included patients treated with thalidomide (Thal) (n = 474), the second group with lenalidomide (Len) (n = 140) and patients in the third group were first treated with Thal followed by Len (Thal-Len) (n = 94). Absolute risk of AD was 0.4% for patients treated with Thal, 4.3% for Len and 1.1% for Thal-Len. ADs manifested prevalently as autoimmune cytopenias (55%), although we observed one vasculitis, one optic neuritis, one Graves' disease and one polymyositis. ADs occurred preferentially in the first months of IMiD treatment. A previous autologous transplant was shown to be a significant risk factor. All ADs were managed with IMiD discontinuation and steroids, resolving in a few weeks, except for Graves' disease and polymyositis.
authors.affiliation: Hematology-Bone Marrow transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan , Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Montefusco
authors.forename: Monica
authors.initials: M
authors.lastname: Galli
authors.forename: Francesco
authors.initials: F
authors.lastname: Spina
authors.forename: Paola
authors.initials: P
authors.lastname: Stefanoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Mussetti
authors.forename: Giulia
authors.initials: G
authors.lastname: Perrone
authors.forename: Chiara
authors.initials: C
authors.lastname: De Philippis
authors.forename: Serena
authors.initials: S
authors.lastname: Dalto
authors.forename: Francesco
authors.initials: F
authors.lastname: Maura
authors.forename: Chiara
authors.initials: C
authors.lastname: Bonini
authors.forename: Francesca
authors.initials: F
authors.lastname: Rezzonico
authors.forename: Martina
authors.initials: M
authors.lastname: Pennisi
authors.forename: Luisa
authors.initials: L
authors.lastname: Roncari
authors.forename: Martina
authors.initials: M
authors.lastname: Soldarini
authors.forename: Anna
authors.initials: A
authors.lastname: Dodero
authors.forename: Lucia
authors.initials: L
authors.lastname: Farina
authors.forename: Federica
authors.initials: F
authors.lastname: Cocito
authors.forename: Chiara
authors.initials: C
authors.lastname: Caprioli
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications* / Q000175:diagnosis; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D015994:Incidence; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Multiple myeloma; autoimmune diseases; lenalidomide; thalidomide