The efficacy of combination therapy with lenalidomide and dexamethasone in the treatment of relapsed multiple myeloma

• Autorzy: Szudy-Szczyrek A. , Legiec W. , Manko J. , Gmyz K. , Szczyrek M. , Hus M.
• Języki publikacji: EN

Abstrakty

EN

Multiple myeloma is a neoplastic disease which is characterised by proliferation of monoclonal plasmocytes in the bone marrow. It is the second most common hematologic cancer and it represents 1% of all cancer deaths. Despite enormous development in multiple myeloma biology and treatment over the last 30 years - it is still incurable disease with a median survival of 50 – 55 months. Currently, one of the most important goals in the treatment of multiple myeloma is to achieve long-term control of the disease, without negative impact on the patient’s quality of life. Thanks to therapeutic regimens based on new immunomodulatory drugs, this aim seems to be achievable. In this paper we present the case of a female patient living with multiple myeloma for 14 years. Initially patient was treated with standard VAD (vincristine, doxorubicin, dexamethasone) chemotherapy regimen. After a nearly complete remission of the disease, autotransplantation of hematopoietic cells was performed. One year after transplantation there was a relapse of the disease. In the treatment of relapse it was decided to use scheme based on lenalidomide and dexamethasone. After 4th cycle of treatment, a complete remission was achieved. So far, the patient received 149 cycles. In the evaluation of minimal residual disease still maintains a state of complete remission maintains. During over 12 years of treatment no complications in grade 3 and 4 of the CTCAE v.4 was observed. Currently the patient is 58 years old, she still receives lenalidomide and leads moderately active life.

Słowa kluczowe

EN

human disease; neoplastic disease; combination therapy; therapy; lenalidomide; dexamethasone; treatment; multiple myeloma; immunomodulatory drug

• Wydawca: -
• Czasopismo: Health Problems of Civilization
• Rocznik: 2015
• Tom: 09
• Numer: 2
• Opis fizyczny: p.50-54,fig.,ref.

Twórcy

autor

Szudy-Szczyrek A.

• Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland

autor

Legiec W.

• Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland

autor

Manko J.

• Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland

autor

Gmyz K.

• Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland

autor

Szczyrek M.

• Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University of Lublin, Lublin, Poland

autor

Hus M.

• Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland

Bibliografia

• 1. Alegre A., Oriol-Rocafiguera A., Garcia-Larana J., Mateos M.V., Sureda A., Martinez-Chamorro C., Cibeira M.T., Aguado B., Knight R., Rosettani B. (2012), Efficacy, safety and quality-of-life associated with lenalidomide plus dexamethasone for the treatment of relapsed or refractory multiple myeloma: the Spanish experience. Leuk Lymphoma; 53:1714-21.
• 2. Attal M., Harousseau J.L., Stoppa A.M., Sotto J.J., Fuzibet J.G., Rossi J.F., Casassus P., Maisonneuve H., Facon T., Ifrah N., Payen C., Bataille R. (1996), A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med.; 335: 91–7.
• 3. Child J.A., Morgan G.J., Davies F.E., Owen R.G., Bell S.E., Hawkins K., Brown J., Drayson M.T., Selby P.J., Medical Research Council Adult Leukaemia Working Party. (2003), High-dose chemotherapy with hematopoietic stemcell rescue for multiple myeloma. N Engl J Med.; 348: 1875–83.
• 4. Davies F.E., Raje N., Hideshima T., Lentzsch S., Young G., Tai Y.T., Lin B., Podar K., Gupta D., Chauhan D., Treon S.P., Richardson P.G., Schlossman R.L., Morgan G.J., Muller G.W., Stirling D.I., Anderson K.C. (2001), Thalidomide and immunomodulatory derivatives augment natural killer cell cytotoxicity in multiple myeloma. Blood; 98: 210-216.
• 5. Dimopoulos M., Spencer A., Attal M., Prince H.M., Harousseau J.L., Dmoszynska A., San Miguel J., Hellmann A., Facon T., Foà R., Corso A., Masliak Z., Olesnyckyj M., Yu Z., Patin J., Zeldis J.B., Knight R.D.; Multiple Myeloma (010) Study Investigators. (2007), Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med.; 357: 2123-32.
• 6. Dimopoulos M.A., Chen C., Spencer A., Niesvizky R., Attal M., Stadtmauer E.A., Petrucci M.T., Yu Z., Olesnyckyj M., Zeldis J.B., Knight R.D., Weber D.M. (2009), Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma. Leukemia; 23: 2147-52.
• 7. Gupta D., Treon S.P., Shima Y., Hideshima T., Podar K., Tai Y.T., Lin B., Lentzsch S., Davies F.E., Chauhan D., Schlossman R.L., Richardson P., Ralph P., Wu L., Payvandi F., Muller G., Stirling D.I., Anderson K.C. (2001), Adherence of multiple myeloma cells to bone marrow stromal cells upregulates vascular endothelial growth factor secretion: therapeutic applications. Leukemia; 15: 1950-61.
• 8. Harousseau J.L., Dimopoulos M.A., Wang M., Corso A., Chen C., Attal M., Spencer A., Yu Z., Olesnyckyj M., Zeldis J.B., Knight R.D., Weber D.M. (2010), Better quality of response to lenalidomide plus dexamethasone is associated with improved clinical outcomes in patients with relapsed or refractory multiple myeloma. Haematologica; 95: 1738-44.
• 9. Kumar S.K., Rajkumar S.V., Dispenzieri A., Lacy M.Q., Hayman S.R., Buadi F.K., Zeldenrust S.R., Dingli D., Russell S.J., Lust J.A., Greipp P.R., Kyle R.A., Gertz M.A. (2008), Improved survival in multiple myeloma and the impact of novel therapies. Blood; 111: 2516-20.
• 10. Mitsiades N., Mitsiades C.S., Poulaki V., Chauhan D., Richardson P.G., Hideshima T., Munshi N.C., Treon S.P., Anderson K.C. (2002), Apoptotic signaling induced by immunomodulatory thalidomide analogs in human multiple myeloma cells: therapeutic implications. Blood; 99: 4525-30
• 11. San-Miguel J.F., Dimopoulos M.A., Stadtmauer E.A., Rajkumar S.V., Siegel D., Bravo M.L., Olesnyckyj M., Knight R.D., Zeldis J.B., Harousseau J.L., Weber D.M. (2011), Effects of lenalidomide and dexamethasone treatment duration on survival in patients with relapsed or refractory multiple myeloma treated with lenalidomide and dexamethasone. Clin Lymphoma Myeloma Leuk.; 11: 38-43.
• 12. Weber D.M., Chen C., Niesvizky R., Wang M., Belch A., Stadtmauer E.A., Siegel D., Borrello I., Rajkumar S.V., Chanan-Khan A.A., Lonial S., Yu Z., Patin J., Olesnyckyj M., Zeldis J.B., Knight R.D.; Multiple Myeloma (009) Study Investigators. (2007), Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med.; 357: 2133-42.