Lenalidomide induced good clinical response in a patient with multiple relapsed and refractory Hodgkin's lymphoma
© Mandac and Kolonic; licensee BioMed Central Ltd. 2010
Received: 29 April 2010
Accepted: 28 May 2010
Published: 28 May 2010
A 24-year-old female patient was diagnosed with classic Hodgkin's lymphoma in clinical stage II, and combination chemotherapy followed by radiotherapy was initiated. During the following 5 years, the disease progressed despite several standard therapeutic approaches, including autologous and allogeneic stem cell transplantation.
Lenalidomide (25 mg daily) treatment was then initiated in a continuous dosing schedule. Positron emission tomography scans were performed before and during lenalidomide treatment. Hematologic and laboratory values, as well as physical condition were also assessed before and during lenalidomide treatment.
Four months after continuous lenalidomide treatment, tumor load was significantly reduced, B symptoms had resolved, and the patient's physical condition had improved, allowing her to resume normal daily-living activities. Evaluations after 15 months of lenalidomide treatment indicated limited disease progression. Nevertheless, the patient was feeling well and maintaining a normal active life. Treatment was well tolerated, allowing the patient to remain on continuous dosing, which has now been maintained for 18 months.
Daily, long-term lenalidomide treatment provided clinical benefit and was well tolerated in a patient with relapsed, advanced classic Hodgkin's lymphoma.
To the editor
Results of laboratory tests before initiation of lenalidomide treatment and after 12 months of continuous treatment.
Values before lenalidomide treatment
Values after 12 months of lenalidomide (25 mg/day) treatment
White cell count (× 109/L)
Red cell count (× 1012/L)
Platelet count (× 109/L)
Mean corpuscular volume (fL)
Erythrocyte sedimentation rate (mm/3.6 ks)
Total protein (g/L)
C-reactive protein (mg/L)
Lactate dehydrogenase (U/L)
Aspartate aminotransferase (U/L)
Alanine aminotransferase (U/L)
Gamma-glutamyl transpeptidase (U/L)
Alkaline phosphatase (U/L)
3.1 (blood urea)
The lenalidomide dose selected for this patient was based on the standard dose used in multiple myeloma, non-Hodgkin's lymphoma, and classic Hodgkin's lymphoma (25 mg daily for 21 days of every 28-day cycle) [1–4]. In this patient, no significant hematologic toxicity was detected with continuous lenalidomide, which has been ongoing for 18 months. The observed efficacy is consistent with data reported from two small studies [3, 4]. Further clinical studies are needed to assess the clinical utility of lenalidomide in this indication, and to inform prescribing decisions on the most appropriate dose regimen.
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