Lenalidomide and Rituximab in Waldenstrom's Macroglobulinemia
Purpose: Thalidomide and its more potent immunomodulatory derivative lenalidomide enhance rituximab-mediated antibody-dependent cell-mediated cytotoxicity. We therefore evaluated lenalidomide and rituximab in symptomatic Waldenstrom's macroglobulinemia (WM) patients naive to either agent. Exper...
Saved in:
Published in | Clinical cancer research Vol. 15; no. 1; pp. 355 - 360 |
---|---|
Main Authors | , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Association for Cancer Research
01.01.2009
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Purpose: Thalidomide and its more potent immunomodulatory derivative lenalidomide enhance rituximab-mediated antibody-dependent cell-mediated
cytotoxicity. We therefore evaluated lenalidomide and rituximab in symptomatic Waldenstrom's macroglobulinemia (WM) patients
naive to either agent.
Experimental Design: Intended therapy consisted of 48 weeks of lenalidomide (25 mg/d for 3 weeks and then 1 week off) along with rituximab (375
mg/m 2 /wk) dosed on weeks 2 to 5 and 13 to 16. Sixteen patients were enrolled, 12 of whom were previously untreated.
Results: Unexpectedly, we observed an acute decrease in hematocrit in 13 of 16 patients (median hematocrit decrease, 4.8%), which
was attributable to lenalidomide patients and which led to cessation of further enrollment on this study. Lenalidomide-related
anemia was observed even at doses as low as 5 mg/d and occurred in the absence of hemolysis or other cytopenias. The overall
response and major response (<50% decrease in serum IgM) rates were 50% and 25%, respectively, on an intent-to-treat basis.
With a median follow-up of 31.3 months, 4 of 8 responding patients have progressed with a median time to progression of 18.9
months.
Conclusion: Lenalidomide produces unexpected but clinically significant acute anemia in patients with WM. In comparison with our previous
study with thalidomide and rituximab in an analogous patient population, the responses achieved in WM patients with lenalidomide
and rituximab appear less favorable. |
---|---|
ISSN: | 1078-0432 1557-3265 |
DOI: | 10.1158/1078-0432.CCR-08-0862 |