Ayşe UYSAL, Mustafa MERTER

Lenalidomide treatment in relapsed/refractory B-cell lymphomas: A single center real-life experience

As an immunomodulatory drug, lenalidomide has been shown to have anti-lymphoma activity and is used in combination with several agents in the treatment of patients with relapsed/refractory disease. In this study, we aimed to evaluate the efficiency of lenalidomide in the treatment of B-cell NHL. This retrospective study included patients with relapsed/refractory B-cell NHL who received lenalidomide treatment between March 2018 and January 2021. Patients’ demographic data, dose, and duration of the lenalidomide treatment, combined agents, response rates, side effects, and survival rates were evaluated. Twelve patients who diagnosed with relapsed/refractory NHL were included in the study. Lenalidomide treatment was initiated in combination with rituximab for nine of these patients and with temozolomide for the remaining three of them. At the initiation of the lenalidomide treatment, patients’ median age was 72.5 (24-83) years. Number of females/males was 9/3. Nine of the patients were diagnosed with diffuse large b-cell lymphoma (DLBCL), 3 of whom had isolated central nervous system lymphoma (CNS) and 1 had Richter transformation of chronic lymphocytic leukemia. Two patients were diagnosed with mantle cell lymphoma (MCL) and 1 patient was diagnosed with marginal zone lymphoma. The median treatment duration was 4 (1-20) months. In the response assessment, 4 patients had complete response while progressed disease was observed in 5 patients. Three patients died before response assessment. In the median 33-month follow-up, progression-free survival and total survival were found as 4 (1-20) and 7 (1-22) months respectively. Due to its low toxicity profile and activity, lenalidomide could be a good option especially for elderly and fragile B-cell lymphoma patients. It is an agent to be considered particularly in lymphomas with CNS involvement with its good CNS penetration. Its synergistic effect may give better results when used in combination with several anti-lymphoma drugs.

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