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

Vittorio Montefusco, Monica Galli, Francesco Spina, Paola Stefanoni, Alberto Mussetti, Giulia Perrone, Chiara De Philippis, Serena Dalto, Francesco Maura, Chiara Bonini, Francesca Rezzonico, Martina Pennisi, Luisa Roncari, Martina Soldarini, Anna Dodero, Lucia Farina, Federica Cocito, Chiara Caprioli, Paolo Corradini

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)2032-2037
Number of pages6
JournalLeukemia and Lymphoma
Volume55
Issue number9
DOIs
Publication statusPublished - 2014

Keywords

  • Autoimmune diseases
  • Lenalidomide
  • Multiple myeloma
  • Thalidomide

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research
  • Medicine(all)

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