Low-dose lenalidomide and dexamethasone combination treatment in elderly patients with relapsed and refractory multiple myeloma

ABSTRACT

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.

Conclusion: Low-dose lenalidomide in combination with dexamethasone is an effective and safe treatment for relapsed and refractory MM in elderly patients.

KEYWORDS:

• Multiple myeloma
• refractory
• recurrence
• elderly
• lenalidomide
• dexamethasone

Acknowledgements

This study was conducted in accordance with the declaration of Helsinki and was conducted with approval from the Ethics Committee of Huai’an First People's Hospital, Nanjing Medical University. Written informed consent was obtained from all participants.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by Natural Science Foundation of Jiangsu Province [grant number BK20141254]; ‘333 projects’ Foundation of Jiangsu Province [grant number BRA2015152]; and ‘Six talent peaks project’ Foundation of Jiangsu Province [grant number 2013-WSN-017]; and [grant number 2015-WSN-099]