2017 Volume 43 Issue 10 Pages 563-568
Lenalidomide is used to treat multiple myeloma and is renally excreted. It is difficult to specify the appropriate dose of lenalidomide based on kidney function alone owing to the expected improvement of kidney function after treatment and the influence of pretreatment. Therefore, we investigated the relationship between proper usage of the initial dose of lenalidomide based on renal function and treatment duration. Between July 2012 and January 2017, we included 69 subjects using lenalidomide at Ogaki Municipal Hospital. The appropriate dosage for each renal function was evaluated using the package insert; the patient's renal function was evaluated using the Cockcroft-Gault formula. We analyzed the patient background and treatment duration and continuity.
The subjects were assessed and divided into the appropriate dose group (I; 43/69 (62％)), overdose group (II; 18/69 (26％)), and underdose group (III; 8/69 (12％)). On assessing the patient background, the number of patients who underwent pretreatment was significantly higher in Group III than that in other groups (I: II: III= 2: 2: 4 course, P = 0.02). No difference was observed for the duration of treatment and discontinuation due to side effects.
We conclude that patients were concerned about side effects when the pretreatment period was longer and thus the initial dose was reduced. However, there was no significant difference in the treatment duration and the incidence of side effects. Therefore, pharmacists must actively participate in specifying the lenalidomide dosage during treatment continuation from the initial dose.
