title: Pharmacokinetics of lenalidomide during high cut-off dialysis in a patient with multiple myeloma and renal failure.
abstract: BACKGROUND
  High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy.
  
  
  METHODS
  The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in order to develop a pharmacokinetic model accounting for lenalidomide concentrations in this setting.
  
  
  RESULTS
  According to our model, the area under the curve was 3273 µg h/L, i.e., 60% higher than expected under usual dosage (25 mg q.d.) with normal renal function. Despite this, the patient did not develop major hematological toxicity.
  
  
  CONCLUSIONS
  Lenalidomide doses of 5 mg b.i.d. led to high exposure in a patient with renal failure undergoing high cut-off dialysis. Yet, the dosage of 5 mg q.d. recommended in conventional dialysis would probably be adequate in such patients.
authors.affiliation: Division of Clinical Pharmacology, Biomedicine, Department of Laboratories, CHUV, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1011, Lausanne, Switzerland. kim.dao@chuv.ch.
authors.forename: Kim
authors.identifier: http://orcid.org/0000-0002-6033-3435
authors.initials: K
authors.lastname: Dao
authors.affiliation: Service of Nephrology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Cody J
authors.initials: CJ
authors.lastname: Peer
authors.affiliation: Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Figg
authors.affiliation: Division of Hematology, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Stadelmann
authors.affiliation: Service of Nephrology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
authors.affiliation: Division of Clinical Pharmacology, Biomedicine, Department of Laboratories, CHUV, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1011, Lausanne, Switzerland.
authors.forename: Thierry
authors.initials: T
authors.lastname: Buclin
authors.affiliation: Service of Nephrology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Kissling
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D006435:Renal Dialysis; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: High cut-off membrane; High-flux dialysis; Lenalidomide; Pharmacokinetics