Active Ingredient: Lenalidomide
Revlimid as monotherapy is indicated for the treatment of adult patients with transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality when other therapeutic options are insufficient or inadequate.
For this indication, competent medicine agencies globally authorize below treatments:
Oral
10 mg
10 mg once every day
Lenalidomide treatment must not be started if the ANC <0.5 × 109/L and/or platelet counts <25 × 109/L.
Recommended dose: The recommended starting dose of lenalidomide is 10 mg orally once daily on days 1 to 21 of repeated 28-day cycles.
Dose reduction steps:
| Starting dose | 10 mg once daily on days 1 to 21 every 28 days |
| Dose level -1 | 5 mg once daily on days 1 to 28 every 28 days |
| Dose level -2 | 2.5 mg once daily on days 1 to 28 every 28 days |
| Dose level -3 | 2.5 mg every other day 1 to 28 every 28 days |
Thrombocytopenia:
| When platelets | Recommended course |
|---|---|
| Fall to <25 × 109/L | Interrupt lenalidomide treatment |
| Return to ≥25 × 109/L - <50 × 109/L on at least 2 occasions for ≥7 days or when the platelet count recovers to ≥50 × 109/L at any time | Resume lenalidomide at next lower dose level (dose level -1, -2 or -3) |
Patients without at least a minor erythroid response within 4 months of therapy initiation, demonstrated by at least a 50% reduction in transfusion requirements or, if not transfused, a 1g/dl rise in haemoglobin, should discontinue lenalidomide treatment.
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