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Post-transplant Events

Lenalidomide as salvage therapy after allo-SCT for multiple myeloma is effective and leads to an increase of activated NK (NKp44+) and T (HLA-DR+) cells

Bone Marrow Transplantation volume 45, pages 349–353 (2010)Cite this article

Abstract

We investigated efficacy and toxicity of lenalidomide in 24 heavily pretreated myeloma patients with a median age of 59 years (range: 37–70) and relapse after allo-SCT. Lenalidomide was given at a dose of 15 mg (n=4), or 25 mg (n=20), orally once daily on day 1 to day 1 every 28 days, with (n=20) or without (n=4) DHAP. The median number of lenalidomide cycles was five (range: 2–17). Major side effects were leukopenia (grade 4: 4%, grade 3: 21% and grade 2: 17%) and thrombocytopenia (grade 3: 17% and grade 2: 29%); infectious complications were observed in 50%. Non-hematological toxicity consisted of muscle cramps (n=9), fatigue (n=5) and constipation (n=2). Mild grade I–II GVHD was seen in three patients. Response was achieved in 66%: CR in 8%, VGPR in 8%, PR in 50% and SD in 13%. The median time to progression was 9.7 months (95% confidence interval (CI): 7.5–11.9), and median OS was 19.9 months (95% CI: 17.3–22.5). Immunomonitoring after lenalidomide showed significant increase of activated NK (NKp44+) and T (HLA-DR+) cells, as well as regulatory T cells (CD4+, CD25+, CD127lo), supporting an immunomodulating anti-myeloma effect of lenalidomide.

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Acknowledgements

We thank the staff of the BMT unit for providing excellent care of our patients, and the medical technicians for their excellent work in the laboratories. This work was supported in part by a grant from the Deutsche José Carreras Leukämie-Stiftung e.V. (to NK)

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Authors and Affiliations

  1. Department for Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    M Lioznov, F Hoffmann, Y Hildebrandt, F Ayuk, C Wolschke, A Badbaran, U Bacher, B Fehse, A R Zander & N Kröger

  2. Unité de Transplantation et de Thérapie Cellulaire (UTTC), Institut Paoli Calmettes, Marseille, France

    J El-Cheikh Jr & D Blaise

  3. Department for Oncology/Hematology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    D Atanackovic & G Schilling

  4. CHU de Nantes, Hematologie Clinique, Universite de Nantes and INSERM, Nantes Cedex, France

    M Mohty

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  1. M Lioznov
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Correspondence to N Kröger.

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Lioznov, M., El-Cheikh, J., Hoffmann, F. et al. Lenalidomide as salvage therapy after allo-SCT for multiple myeloma is effective and leads to an increase of activated NK (NKp44+) and T (HLA-DR+) cells. Bone Marrow Transplant 45, 349–353 (2010). https://doi.org/10.1038/bmt.2009.155

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