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Chronic lymphocytic leukaemia: Lenalidomide safe as single therapy in elderly

Lenalidomide ( Revlimid ) is safe and well-tolerated for elderly patients with chronic lymphocytic leukaemia ( CLL ), a group without a well-defined frontline therapy for their disease, researchers from The University of Texas M. D. Anderson Cancer Center reported at the American Society of Hematology Meeting.

Patients start on a 5 mg dose of the drug in pill form and the dose escalates over time in 5 mg increments to a maximum of 25 mg. The median age of participants was 72. Chemo-immunotherapy therapy combinations that are effective in younger patients with chronic lymphocytic leukemia tend to be associated with a high rate of complications in patients older than 70.

Of 43 patients enrolled in the study, 35 were evaluable because they had been treated for at least three months. Nineteen of these ( 54 percent ) achieved a partial response, where the disease is diminished, 14 patients ( 40 percent ) had stable disease and continue on therapy, and two had their CLL progress.

Lenalidomide also rapidly has reduced the number of circulating lymphocytes – the hallmark of the disease – in the patients' blood; 47 percent achieved a blood complete response and 38 percent had at least a partial response.

Patients on the trial for at least two months were evaluated for the drug's potential side effects. Of those 39 patients, 10 ( 26 percent ) had decreased bone marrow activity resulting in a decrease in the number of either white blood cells called neutrophils or of platelets. Three patients had infections, two had fever and one had pneumonia.

All patients registered in the study remain alive with 37 of the 43 continuing on treatment.  ( Xagena )

Source: University of Texas MD Anderson Cancer Center, 2008