Lenalidomide in relapsed refractory non-Hodgkin's lymphoma: An Indian perspective

Lenalidomide an immunomodulatory agent has shown activity in relapsed/refractory lymphoma. This study was conducted to evaluate its efficacy and optimal dose in Indian patients with relapsed/refractory lymphoma who were unable or unwilling to undergo autologous hematopoietic stem cell transplant.

Patients received oral lenalidomide at 20 mg on days 1-21 every 28 days until disease progression or unacceptable toxicity.

A total of 25 patients received lenalidomide at a starting dose of 20 mg. Majority of patients were diffuse large B-cell lymphoma (DLBCL). The overall response rate (ORR) was 48%, with 16% achieved complete remission (CR)/unconfirmed CR (CRu), 32% partial response (PR) and 16% stable disease (SD) Among patients with DLBCL the ORR was of 33.3%; with CR/CRu 20%, PR (13.3%), 20% had SD, progressive disease (PD) was seen in seven patients (46.6%). All follicular lymphoma patients responded to treatment, with CR in one patient and PR in other two. Among patients with mantle cell lymphoma, ORR was 75% with PR in (75%) and SD in 25%. One case of transformed lymphoma had a PR and peripheral T-cell lymphoma had no response to treatment. The median duration of response was 8.5 months, with a time to response of 3 months. Median progression free survival was not reached in responding patients.

Lenalidomide is an effective treatment option in relapsed refractory non hodgkin's lymphoma.