Autoimmune diseases during treatment with immunomodulatory drugs in multiple myeloma: selective occurrence after lenalidomide

被引:20
作者
Montefusco, Vittorio [1 ]
Galli, Monica [2 ]
Spina, Francesco [1 ]
Stefanoni, Paola [2 ]
Mussetti, Alberto [1 ]
Perrone, Giulia [1 ]
De Philippis, Chiara [1 ]
Dalto, Serena [1 ]
Maura, Francesco [1 ]
Bonini, Chiara [3 ]
Rezzonico, Francesca [1 ]
Pennisi, Martina [1 ]
Roncari, Luisa [1 ]
Soldarini, Martina [1 ]
Dodero, Anna [1 ]
Farina, Lucia [1 ]
Cocito, Federica [4 ]
Caprioli, Chiara [2 ]
Corradini, Paolo [1 ,5 ]
机构
[1] Fdn IRCCS Ist Nazl Tumori, I-20133 Milan, Italy
[2] Hosp Papa Giovanni XXIII, Bergamo, Italy
[3] Fdn IRCCS Ist Nazl Tumori, Clin Lab, I-20133 Milan, Italy
[4] Hosp San Matteo, Pavia, Italy
[5] Univ Milan, Chair Hematol, Milan, Italy
关键词
Multiple myeloma; lenalidomide; thalidomide; autoimmune diseases; CHRONIC LYMPHOCYTIC-LEUKEMIA; VERSUS-HOST-DISEASE; HEMOLYTIC-ANEMIA; PLUS DEXAMETHASONE; LYMPHOMA; CELLS;
D O I
10.3109/10428194.2014.914203
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Immunomodulatory drugs (IMiDs) may favor autoimmune disease (AD) occurrence. We conducted a retrospective study to evaluate AD occurrence among IMiD-treated patients with myeloma. Patients were grouped into three classes depending on the type of IMiD engaged. The first group included patients treated with thalidomide (Thal) (n = 474), the second group with lenalidomide (Len) (n = 140) and patients in the third group were first treated with Thal followed by Len (Thal-Len) (n = 94). Absolute risk of AD was 0.4% for patients treated with Thal, 4.3% for Len and 1.1% for Thal-Len. ADs manifested prevalently as autoimmune cytopenias (55%), although we observed one vasculitis, one optic neuritis, one Graves' disease and one polymyositis. ADs occurred preferentially in the first months of IMiD treatment. A previous autologous transplant was shown to be a significant risk factor. All ADs were managed with IMiD discontinuation and steroids, resolving in a few weeks, except for Graves' disease and polymyositis.
引用
收藏
页码:2032 / 2037
页数:6
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