Nakaya Aya, Fujita Shinya, Satake Atsushi, Nakanishi Takahisa, Azuma Yoshiko, Tsubokura Yukie, Hotta Masaaki, Yoshimura Hideaki, Ishii Kazuyoshi, Ito Tomoki, Nomura Shosaku
First Department of Internal Medicine, Kansai Medical University, Hirakata, Japan.
Acta Haematol. 2017;138(1):55-60. doi: 10.1159/000477792. Epub 2017 Jul 21.
Lenalidomide is an immunomodulatory drug administered orally in the treatment of multiple myeloma. Some elderly patients require a reduced lenalidomide dose because of comorbidities and/or adverse events. This study investigated the actual dose of lenalidomide in elderly patients, finding that most received reduced (5-10 mg) doses. The most common reasons for dose reduction were renal dysfunction (54% of patients), fatigue (grade ≥3; 20%), hematologic disorder (grade ≥3; 14%), and rash (grade ≥3; 9%). Their median time to progression was 11.8 months and their median overall survival was 39.2 months. The overall response rate was 73%, including 17% with a complete response, 19% with a very good partial response, and 37% with a partial response. These results showed that, contrary to western countries, most patients were treated with a reduced dose of lenalidomide in Japan. However, it is suggested that continued treatment with a tolerable dose may yield favorable outcomes.
来那度胺是一种用于治疗多发性骨髓瘤的口服免疫调节药物。一些老年患者由于合并症和/或不良事件需要降低来那度胺剂量。本研究调查了老年患者来那度胺的实际剂量，发现大多数患者接受了降低剂量（5-10毫克）的治疗。剂量降低的最常见原因是肾功能不全（54%的患者）、疲劳（≥3级；20%）、血液系统疾病（≥3级；14%）和皮疹（≥3级；9%）。他们的中位疾病进展时间为11.8个月，中位总生存期为39.2个月。总缓解率为73%，包括17%的完全缓解、19%的非常好的部分缓解和37%的部分缓解。这些结果表明，与西方国家相反，日本大多数患者接受的是降低剂量的来那度胺治疗。然而，有迹象表明，使用可耐受剂量持续治疗可能会产生良好的结果。
