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

Kim Dao*, Yimin Lu, Cody J. Peer, William D. Figg, Raphael Stadelmann, Michel Burnier, Thierry Buclin, Sebastien Kissling

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish
Pages (from-to)215-218
Number of pages4
JournalCancer Chemotherapy and Pharmacology
Volume79
Issue number1
DOIs
StatePublished - 1 Jan 2017
Externally publishedYes

Keywords

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

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