Single agent lenalidomide three times a week induces hematologic responses in AL amyloidosis patients on dialysis

Am J Hematol. 2014 Jul;89(7):706-8. doi: 10.1002/ajh.23722. Epub 2014 Apr 10.


The combination of lenalidomide and dexamethasone can produce hematologic responses in previously treated patients with AL amyloidosis. Because lenalidomide is primarily excreted unchanged by the kidney, adjustments to the starting dose of lenalidomide are recommended to provide appropriate drug exposure in patients with moderate or severe renal impairment and in patients on dialysis. Here, we report on a study of patients with AL amyloidosis on dialysis treated with lenalidomide at a dose of 10 mg orally three times a week. Seven patients were enrolled. All patients had received prior treatment, with 57% receiving prior high-dose melphalan and stem cell transplantation. Two patients died before evaluation of response. The most common adverse event was infection; no thromboembolic complications were seen. One patient required dose-modification. Hematologic responses were obtained by four of the five evaluable patients. Median overall survival was 18 months. In conclusion, adjusted dose lenalidomide was reasonably tolerated and induced sustained hematologic responses in previously treated patients with AL amyloidosis on dialysis.

Trial registration: NCT00091260.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Amyloidosis / blood
  • Amyloidosis / drug therapy*
  • Angiogenesis Inhibitors / administration & dosage*
  • Angiogenesis Inhibitors / adverse effects
  • Dexamethasone / administration & dosage*
  • Dexamethasone / adverse effects
  • Dialysis
  • Drug Administration Schedule
  • Female
  • Humans
  • Kidney Diseases / metabolism
  • Kidney Diseases / therapy
  • Lenalidomide
  • Male
  • Middle Aged
  • Survival Analysis
  • Thalidomide / administration & dosage
  • Thalidomide / adverse effects
  • Thalidomide / analogs & derivatives*
  • Treatment Outcome


  • Angiogenesis Inhibitors
  • Thalidomide
  • Dexamethasone
  • Lenalidomide

Associated data