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

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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.

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Authors and Affiliations

  1. Division of Clinical Pharmacology, Biomedicine, Department of Laboratories, CHUV, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1011, Lausanne, Switzerland

    Kim Dao & Thierry Buclin

  2. Service of Nephrology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

    Yimin Lu, Michel Burnier & Sebastien Kissling

  3. Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA

    Cody J. Peer & William D. Figg

  4. Division of Hematology, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

    Raphael Stadelmann

Authors
  1. Kim Dao
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  2. Yimin Lu
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  3. Cody J. Peer
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  4. William D. Figg
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  5. Raphael Stadelmann
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  6. Michel Burnier
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  7. Thierry Buclin
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  8. Sebastien Kissling
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Corresponding author

Correspondence to Kim Dao.

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Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written and informed consent was obtained from the patient included in the study.

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Dao, K., Lu, Y., Peer, C.J. et al. Pharmacokinetics of lenalidomide during high cut-off dialysis in a patient with multiple myeloma and renal failure. Cancer Chemother Pharmacol 79, 215–218 (2017). https://doi.org/10.1007/s00280-016-3219-z

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  • DOI: https://doi.org/10.1007/s00280-016-3219-z

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