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Cancer Chemother Pharmacol. 2017 Jan;79(1):215-218. doi: 10.1007/s00280-016-3219-z. Epub 2016 Dec 17.

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

Author information

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@chuv.ch.
2
Service of Nephrology, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
3
Clinical Pharmacology Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
4
Division of Hematology, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
5
Division of Clinical Pharmacology, Biomedicine, Department of Laboratories, CHUV, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 17, 1011, Lausanne, Switzerland.

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.

KEYWORDS:

High cut-off membrane; High-flux dialysis; Lenalidomide; Pharmacokinetics

PMID:
27988790
DOI:
10.1007/s00280-016-3219-z
[Indexed for MEDLINE]

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