Lenalidomide and dexamethasone in the treatment of chronic lymphocytic leukemia

The study looked at the safety and effectiveness of adding dexamethasone (Decadron) to lenalidomide (Revlimid) in previously untreated patients with chronic lymphocytic leukemia (CLL). Researchers concluded that lenalidomide plus dexamethasone is an effective treatment for CLL.

Chronic lymphocytic leukemia (CLL) is a cancer of the bone marrow. It is often linked with abnormal genes and abnormal immune cells. It may be treated with drugs that target the immune system such as lenalidomide. This treatment may have significant side effects such as tumor lysis syndrome (TLS – when dead cancer cells enter the bloodstream and cause damage to other organs) or a tumor flare (symptoms getting worse after starting treatment). Dexamethasone is a steroid medication that reduces inflammation. It is not known if dexamethasone added to lenalidomide treatment may help with these side effects in patients with CLL.

31 previously untreated patients with CLL were included in this study. Lenalidomide was given daily for the study. Dexamethasone was given for the first week and on days 14 and 21 every 28-day cycle of treatment. Patients were given allopurinol (Zyloprim) to prevent TLS. 19 (61%) patients in total completed the treatment. 12 patients stopped treatment before the end. Reasons included side effects (16%), and worsening disease (3.2%).

After 27 months follow-up, 20 (64.5%) patients had a partial response. 3 (9.7%) patients had no signs of disease after treatment (complete response). 60.3% of patients survived without disease for an average of 27 months. For all patients, overall survival after 2 years was 92.6%.

Side effects of lenalidomide included pain (93.5%), rash (64.5%), sleep problems (54.8%), tiredness (51.6%) and swelling (54.8%).

The study found that lenalidomide plus dexamethasone was safe and effective in the treatment of CLL.

This study had a small sample size. Larger research is needed to confirm results.