Lenalidomide: What It Is, How It Is Taken, Side Effects

used in the treatment of various forms of cancers and diseases of the blood and immune system.

Shutterstock Lenalidomide - Chemical Structure

In order to exert its therapeutic action, lenalidomide must be taken orally. In Italy, the active ingredient is available in a single medicinal product called Revlimid®, available in different dosages. In detail, it is a hospital drug (band H) that can be released in pharmacies upon presentation of a limitative non-repeatable medical prescription (or RNRL; drugs that can be sold to the public on prescription from hospital centers or specialists).

newly diagnosed:

• In patients undergoing bone marrow transplant;
• In patients who cannot undergo a bone marrow transplant, in combination with other drugs such as dexamethasone, melphalan or prednisone;
• In patients already undergoing treatment, in combination with dexamethasone.

Of myelodysplastic syndromes (MDS), a "set of different diseases of the bone marrow and blood. In patients diagnosed with these diseases, lenalidomide can be used alone for all of the following conditions:

• Transfusion-dependent anemia;
• Isolated 5q deletion cytogenetic abnormality, a type of bone marrow cell abnormality in which insufficient levels of blood cells are produced;
• Previous treatments unsuitable or insufficient to control the disease.

Mantle cell lymphoma, a type of cancer that affects B lymphocytes that grow uncontrollably, accumulating in the lymphatic tissue, bone marrow or blood. In these cases, lenalidomide is used to treat adult patients previously treated with other medicines.

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You have or have suffered in the past from viral infections, such as hepatitis B, chicken pox or HIV infections, as taking lenalidomide can reactivate the viruses giving rise to new infections;

You have kidney problems

You have suffered from a heart attack in the past, smoke, have high blood pressure and / or have high blood cholesterol levels;

An allergic reaction to thalidomide (another active ingredient used in the treatment of multiple myeloma) has developed in the past;

Combinations of two or more symptoms have occurred in the past such as: rash on the face or larger parts of the skin, redness of the skin, high fever, flu symptoms, swollen lymph nodes; as they may be a sign of a drug reaction with eosinophilia and systemic symptoms (DRESS).

Furthermore, it is important to note that patients with myelodysplastic syndromes have a greater risk of developing acute myeloid leukemia. In this regard, the doctor may decide to subject the patient to specific tests to check for signs that could more accurately predict the likelihood of developing acute myeloid leukemia in individuals treated with lenalidomide.

Exams and analyzes

Before and during treatment with lenalidomide, the doctor will test the patient's blood, as the active substance can lead to a decrease in the levels of all blood cells. In detail, the analyzes will be carried out:

• Before the treatment;
• Every week for the first eight weeks of treatment;
• Thereafter, at least once a month.

In the presence of mantle cell lymphoma, however, the analyzes must be performed:

• Before the treatment;
• Once a week for the first eight weeks (2 cycles) of treatment;
• Every two weeks in treatment cycles 3 and 4;
• Then, at the beginning of each treatment cycle;
• Thereafter, at least once a month.

At the same time, your doctor will need to check if you have a high tumor burden throughout your body, including your bone marrow, as this could lead to tumor lysis syndrome.

Depending on the results obtained from the blood tests, your doctor may decide to modify or discontinue treatment with lenalidomide.