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Salvage lenalidomide in four rare oncological diseases

Abstract

In rare disorders, there are often no standard therapy recommendations. Patients with refractory disease may require novel experimental approaches. Applied as second-up to fourth-line treatment, lenalidomide (10-25 mg perorally on days 1-21 in a 28-day cycle) was used in our cohort of four adult patients with aggressive, multisystem and relapsing diseases. Complete and long-lasting remissions (more than 1 year, no maintenance therapy) were achieved in patients with Langerhans cell histiocytosis (11 cycles, combination with dexamethasone and etoposide, consolidated by allogeneic blood stem cell transplant) and plasma-cell Castleman disease (15 cycles, monotherapy). Mixed response with complete disappearance of brain infiltrates was reached in Erdheim-Chester disease (6 cycles, monotherapy) and gastrointestinal bleeding was well controlled in multiple angiomatosis (9 cycles, combination with thalidomide). For disease activity evaluation each patient underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography scan imaging, which was complemented by clinical and laboratory investigations.

Tumori 2013; 99(5): e251 - e256

Article Type: CASE REPORT

DOI:10.1700/1377.15326

Authors

Petr Szturz, Zdenek Adam, Zdenek Rehak, Renata Koukalova, Leos Kren, Mojmír Moulis, Marta Krejcí1, Jiri Mayer

Article History

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Authors

  • Szturz, Petr [PubMed] [Google Scholar]
    Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, School of Medicine, Brno, Czech Republic
  • Adam, Zdenek [PubMed] [Google Scholar]
    Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, School of Medicine, Brno, Czech Republic
  • Rehak, Zdenek [PubMed] [Google Scholar]
    Department of Nuclear Medicine, PET Center at the Masaryk Memorial Cancer Institute, Brno, Czech Republic
  • Koukalova, Renata [PubMed] [Google Scholar]
    Department of Nuclear Medicine, PET Center at the Masaryk Memorial Cancer Institute, Brno, Czech Republic
  • Kren, Leos [PubMed] [Google Scholar]
    Department of Pathology, University Hospital Brno and Masaryk University, School of Medicine, Brno, Czech Republic
  • Moulis, Mojmír [PubMed] [Google Scholar]
    Department of Pathology, University Hospital Brno and Masaryk University, School of Medicine, Brno, Czech Republic
  • Krejcí1, Marta [PubMed] [Google Scholar]
    Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, School of Medicine, Brno, Czech Republic
  • Mayer, Jiri [PubMed] [Google Scholar]
    Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, School of Medicine, Brno, Czech Republic

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