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Pharmacokinetics of lenalidomide during high cut-off dialysis in a patient with multiple myeloma and renal failure.


ABSTRACT: INTRODUCTION:High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy. METHODS:The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in order to develop a pharmacokinetic model accounting for lenalidomide concentrations in this setting. RESULTS:According to our model, the area under the curve was 3273 µg h/L, i.e., 60% higher than expected under usual dosage (25 mg q.d.) with normal renal function. Despite this, the patient did not develop major hematological toxicity. CONCLUSIONS:Lenalidomide doses of 5 mg b.i.d. led to high exposure in a patient with renal failure undergoing high cut-off dialysis. Yet, the dosage of 5 mg q.d. recommended in conventional dialysis would probably be adequate in such patients.

SUBMITTER: Dao K 

PROVIDER: S-EPMC6410697 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Pharmacokinetics of lenalidomide during high cut-off dialysis in a patient with multiple myeloma and renal failure.

Dao Kim K   Lu Yimin Y   Peer Cody J CJ   Figg William D WD   Stadelmann Raphael R   Burnier Michel M   Buclin Thierry T   Kissling Sebastien S  

Cancer chemotherapy and pharmacology 20161217 1


<h4>Introduction</h4>High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy.<h4>Methods</h4>The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in  ...[more]

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