Immunomodulating agents
Immunomodulating agents are a new class of drugs that
change the expression of various cytokines and costimulate
immune effector cells. Lenalidomide (Revlimid, Celgene) is
a second generation thalidomide analog with possible immu-
nomodulating and antiangiogenic properties, which may also
modulate cytokine activity in the tumor microenvironment.
Lenalidomide is orally available and has significant activity in
multiple myeloma and myelodysplastic syndrome, and most
recently it has been shown to be effective in the treatment of
various lymphoproliferative disorders such as CLL and NHL
[54]. A characteristic AE of treatment with lenalidomide in
CLL is tumor
flare reaction, as well as an immune-modulatory
effect which leads to a sensation of heat and burning in the
lymph nodes. Chanan-Khan et al. investigated the antileuke-
mic effects of lenalidomide in 45 CLL patients with relapsed
or refractory disease [55]. The drug was administered orally at
a dose of 25 mg once a day for 21 days on a 28-day schedule.
Due to the occurrence of tumor lysis syndrome (TLS) in two
of the
first 29 patients, the treatment protocol was revised to
allow slow dose escalation in subsequent patients, in whom
the initial dose was 5 mg, which was increased by 5 mg every
1–2 weeks to a maximum 25 mg. Twenty-nine patients were
assessable for response and all 45 patients were evaluated for
toxicity. The most common nonhematologic AEs were fatigue
(83%) and
flare reaction (58%). Grade 3–4 thrombocytopenia
a c t a h a e m a t o l o g i c a p o l o n i c a 4 5 ( 2 0 1 4 ) 1 2 2 – 1 3 1 127
Immunomodulating agents
Immunomodulating agents are a new class of drugs that
change the expression of various cytokines and costimulate
immune effector cells. Lenalidomide (Revlimid, Celgene) is
a second generation thalidomide analog with possible immu-
nomodulating and antiangiogenic properties, which may also
modulate cytokine activity in the tumor microenvironment.
Lenalidomide is orally available and has significant activity in
multiple myeloma and myelodysplastic syndrome, and most
recently it has been shown to be effective in the treatment of
various lymphoproliferative disorders such as CLL and NHL
[54]. A characteristic AE of treatment with lenalidomide in
CLL is tumor
flare reaction, as well as an immune-modulatory
effect which leads to a sensation of heat and burning in the
lymph nodes. Chanan-Khan et al. investigated the antileuke-
mic effects of lenalidomide in 45 CLL patients with relapsed
or refractory disease [55]. The drug was administered orally at
a dose of 25 mg once a day for 21 days on a 28-day schedule.
Due to the occurrence of tumor lysis syndrome (TLS) in two
of the
first 29 patients, the treatment protocol was revised to
allow slow dose escalation in subsequent patients, in whom
the initial dose was 5 mg, which was increased by 5 mg every
1–2 weeks to a maximum 25 mg. Twenty-nine patients were
assessable for response and all 45 patients were evaluated for
toxicity. The most common nonhematologic AEs were fatigue
(83%) and
flare reaction (58%). Grade 3–4 thrombocytopenia
a c t a h a e m a t o l o g i c a p o l o n i c a 4 5 ( 2 0 1 4 ) 1 2 2 – 1 3 1 127
การแปล กรุณารอสักครู่..
Immunomodulating agents
Immunomodulating agents are a new class of drugs that
change the expression of various cytokines and costimulate
immune effector cells. Lenalidomide (Revlimid, Celgene) is
a second generation thalidomide analog with possible immu-
nomodulating and antiangiogenic properties, which may also
modulate cytokine activity in the tumor microenvironment.
Lenalidomide is orally available and has significant activity in
multiple myeloma and myelodysplastic syndrome, and most
recently it has been shown to be effective in the treatment of
various lymphoproliferative disorders such as CLL and NHL
[54]. A characteristic AE of treatment with lenalidomide in
CLL is tumor
flare reaction, as well as an immune-modulatory
effect which leads to a sensation of heat and burning in the
lymph nodes. Chanan-Khan et al. investigated the antileuke-
mic effects of lenalidomide in 45 CLL patients with relapsed
or refractory disease [55]. The drug was administered orally at
a dose of 25 mg once a day for 21 days on a 28-day schedule.
Due to the occurrence of tumor lysis syndrome (TLS) in two
of the
first 29 patients, the treatment protocol was revised to
allow slow dose escalation in subsequent patients, in whom
the initial dose was 5 mg, which was increased by 5 mg every
1–2 weeks to a maximum 25 mg. Twenty-nine patients were
assessable for response and all 45 patients were evaluated for
toxicity. The most common nonhematologic AEs were fatigue
(83%) and
flare reaction (58%). Grade 3–4 thrombocytopenia
a c t a h a e m a t o l o g i c a p o l o n i c a 4 5 ( 2 0 1 4 ) 1 2 2 – 1 3 1 127
การแปล กรุณารอสักครู่..