Lenalidomide and dexamethasone for acute light chain-induced
renal failure: a phase II study

J 2015

Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study

LUDWIG, Heinz, Elisabeth RAUCH, Thomas KUEHR, Zdeněk ADAM, Adalbert WEISSMANN et. al.

Základní údaje

Originální název

Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study

Autoři

LUDWIG, Heinz (40 Rakousko), Elisabeth RAUCH (40 Rakousko), Thomas KUEHR (40 Rakousko), Zdeněk ADAM (203 Česká republika, domácí), Adalbert WEISSMANN (40 Rakousko), Hedwig KASPARU (40 Rakousko), Eva Maria AUTZINGER (40 Rakousko), Daniel HEINTEL (40 Rakousko), Richard GREIL (40 Rakousko), Wolfram POENISCH (40 Rakousko), Ercan MÜLDÜR (40 Rakousko) a Niklas ZOJER (40 Rakousko)

Vydání

Haematologica, Pavia, Ferrata Storti Foundation, 2015, 0390-6078

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Itálie

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 6.671

Kód RIV

RIV/00216224:14110/15:00084781

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.3324/haematol.2014.115204

UT WoS

000351279900029

Klíčová slova anglicky

MULTIPLE-MYELOMA; CAST NEPHROPATHY; MONOCLONAL GAMMOPATHY; IMPAIRMENT; KIDNEY; BORTEZOMIB; REVERSIBILITY; AGENTS; MANAGEMENT; PROGNOSIS

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 6. 1. 2016 10:04, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

We prospectively evaluated the activity and tolerance of lenalidomide- dexamethasone in 35 patients with acute light chain- induced renal failure. The lenalidomide dose was adapted to the estimated glomerular filtration rate and dexamethasone was given at high dose in cycle one and at low dose thereafter. Four patients died within the first two cycles, and five discontinued therapy leaving 26 patients for the per- protocol analysis. Responses were observed in 24/ 35 ( 68.6%) patients of the intent- to- treat population. Complete response was noted in seven patients ( 20%), very good partial response in three patients ( 8.6%), partial response in 14 patients ( 40%), and min-imal response in one patient ( 2.9%). Renal response was observed in 16 ( 45.7%) patients: five ( 14.2%) achieved complete, four ( 11.4%) partial and seven ( 20%) minor renal responses. Five of 13 patients who were dialysis dependent at baseline became dialysis independent. The median time to myeloma and to renal response was 28 days for both parameters, while the median time to best myeloma and best renal response was 92 and 157 days, respectively. The median estimated glomerular filtration rate increased significantly in patients with partial response or better from 17.1 mL/ min at baseline to 39.1 mL/ min at best response ( P= 0.001). The median progres-sionfree and overall survival was 5.5 and 21.8 months, respectively, in the intent- to- treat population and 12.1 and 31.4 months, respectively, in the per- protocol group. Infections, cardiotoxicity, anemia and thrombocytopenia were the most frequent toxicities. In conclusion, the lenalidomide- dexamethasone regimen achieved rapid and substantial myeloma and renal responses. The trial was registered under EUDRACT number 2008- 006497- 15.

Citovat

LUDWIG, Heinz, Elisabeth RAUCH, Thomas KUEHR, Zdeněk ADAM, Adalbert WEISSMANN, Hedwig KASPARU, Eva Maria AUTZINGER, Daniel HEINTEL, Richard GREIL, Wolfram POENISCH, Ercan MÜLDÜR a Niklas ZOJER. Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study. Haematologica. Pavia: Ferrata Storti Foundation, 2015, roč. 100, č. 3, s. 385-391. ISSN 0390-6078. Dostupné z: https://dx.doi.org/10.3324/haematol.2014.115204.

@article{1317888,
   author = {Ludwig, Heinz and Rauch, Elisabeth and Kuehr, Thomas and Adam, Zdeněk and Weissmann, Adalbert and Kasparu, Hedwig and Autzinger, Eva Maria and Heintel, Daniel and Greil, Richard and Poenisch, Wolfram and Müldür, Ercan and Zojer, Niklas},
   article_location = {Pavia},
   article_number = {3},
   doi = {http://dx.doi.org/10.3324/haematol.2014.115204},
   keywords = {MULTIPLE-MYELOMA; CAST NEPHROPATHY; MONOCLONAL GAMMOPATHY; IMPAIRMENT; KIDNEY; BORTEZOMIB; REVERSIBILITY; AGENTS; MANAGEMENT; PROGNOSIS},
   language = {eng},
   issn = {0390-6078},
   journal = {Haematologica},
   title = {Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study},
   volume = {100},
   year = {2015}
}

TY  - JOUR
ID  - 1317888
AU  - Ludwig, Heinz - Rauch, Elisabeth - Kuehr, Thomas - Adam, Zdeněk - Weissmann, Adalbert - Kasparu, Hedwig - Autzinger, Eva Maria - Heintel, Daniel - Greil, Richard - Poenisch, Wolfram - Müldür, Ercan - Zojer, Niklas
PY  - 2015
TI  - Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study
JF  - Haematologica
VL  - 100
IS  - 3
SP  - 385-391
EP  - 385-391
PB  - Ferrata Storti Foundation
SN  - 03906078
KW  - MULTIPLE-MYELOMA
KW  - CAST NEPHROPATHY
KW  - MONOCLONAL GAMMOPATHY
KW  - IMPAIRMENT
KW  - KIDNEY
KW  - BORTEZOMIB
KW  - REVERSIBILITY
KW  - AGENTS
KW  - MANAGEMENT
KW  - PROGNOSIS
N2  - We prospectively evaluated the activity and tolerance of lenalidomide- dexamethasone in 35 patients with acute light chain- induced renal failure. The lenalidomide dose was adapted to the estimated glomerular filtration rate and dexamethasone was given at high dose in cycle one and at low dose thereafter. Four patients died within the first two cycles, and five discontinued therapy leaving 26 patients for the per- protocol analysis. Responses were observed in 24/ 35 ( 68.6%) patients of the intent- to- treat population. Complete response was noted in seven patients ( 20%), very good partial response in three patients ( 8.6%), partial response in 14 patients ( 40%), and min-imal response in one patient ( 2.9%). Renal response was observed in 16 ( 45.7%) patients: five ( 14.2%) achieved complete, four ( 11.4%) partial and seven ( 20%) minor renal responses. Five of 13 patients who were dialysis dependent at baseline became dialysis independent. The median time to myeloma and to renal response was 28 days for both parameters, while the median time to best myeloma and best renal response was 92 and 157 days, respectively. The median estimated glomerular filtration rate increased significantly in patients with partial response or better from 17.1 mL/ min at baseline to 39.1 mL/ min at best response ( P= 0.001). The median progres-sionfree and overall survival was 5.5 and 21.8 months, respectively, in the intent- to- treat population and 12.1 and 31.4 months, respectively, in the per- protocol group. Infections, cardiotoxicity, anemia and thrombocytopenia were the most frequent toxicities. In conclusion, the lenalidomide- dexamethasone regimen achieved rapid and substantial myeloma and renal responses. The trial was registered under EUDRACT number 2008- 006497- 15.
ER  -

LUDWIG, Heinz, Elisabeth RAUCH, Thomas KUEHR, Zdeněk ADAM, Adalbert WEISSMANN, Hedwig KASPARU, Eva Maria AUTZINGER, Daniel HEINTEL, Richard GREIL, Wolfram POENISCH, Ercan MÜLDÜR a Niklas ZOJER. Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study. \textit{Haematologica}. Pavia: Ferrata Storti Foundation, 2015, roč.~100, č.~3, s.~385-391. ISSN~0390-6078. Dostupné z: https://dx.doi.org/10.3324/haematol.2014.115204.

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