Sustained response to single agent therapy with continuous lenalidomide in a pre-treated high-risk multiple myeloma patient
In multiple myeloma cells, particular genomic alterations, such as del17p, are considered to be associated with higher-risk disease. However, in recent years, the introduction of thalidomide, bortezomib and lenalidomide has substantially enriched the therapeutic armamentarium for both newly diagnosed and relapsed multiple myeloma patients with poor prognosis. We describe the case of such a patient (female, 60 years of age), who refused autologous stem cell transplantation and became refractory to an induction therapy with bortezomib. Subsequently, she did not tolerate a regimen containing thalidomide and therefore was started on maintenance therapy with lenalidomide. After 4 years of treatment, the patient still is in partial remission. Our case demonstrates the long-term efficacy and good tolerability of lenalidomide monotherapy in a pre-treated high-risk multiple myeloma patient. An individually adjusted dose of lenalidomide may be a good option for patients with refractory disease who are unable to tolerate or refuse to undergo autologous stem cell transplantation.