Low-dose lenalidomide and dexamethasone combination treatment in elderly patients with relapsed and refractory multiple myeloma.
OBJECTIVE
This study investigated the efficacy and safety of low-dose lenalidomide combined with dexamethasone in elderly patients with relapsed and refractory multiple myeloma (MM).


METHODS
Thirty-two elderly patients with refractory and recurrent MM (median age: 64 years) were treated with low-dose lenalidomide (LD-R) combined with dexamethasone (D). LD-R (10 mg/d) was administered orally for 21 days and D (40 mg/d) was administered twice a day on days 1-4, 9-12, and 17-20. The treatment lasted 2-8 28-day cycles.


RESULTS
After two cycles, the complete, very good partial, and partial remission rates were 12.5% (4/32), 25.0% (8/32), and 34.4% (11/32), respectively. The overall response rate was 71.9% (23/32). After a 24-month follow-up, 23 patients responded to therapy, three were in complete remission, four were stable, and 16 exhibited disease progression. In addition, median time-to-progression was 13 months. Observed side effects were hypodynamia, gastrointestinal reaction, peripheral neuritis, and mild hypocytosis.


CONCLUSIONS
Low-dose lenalidomide in combination with dexamethasone is an effective and safe treatment for relapsed and refractory MM in elderly patients.
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Chunling
C
Wang
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Zhengmei
Z
He
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Yuye
Y
Shi
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Lijuan
L
Zhang
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Yue
Y
Chen
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Zhi
Z
Chen
a Department of Hematology, Huai'an First People's Hospital , Nanjing Medical University , Huai'an 223300 , Jiangsu , China.
Liang
L
Yu
D000367:Age Factors; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011379:Prognosis; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives
D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide
Multiple myeloma; dexamethasone; elderly; lenalidomide; recurrence; refractory