For renal amyloid, classic therapeutic combination melphalan and prednisone has been supplemented with drugs with different mechanisms of action in this group of patients: high-dose dexamethasone, high-dose dexamethasone with melphalan, combination of vincristine, doxorubicin, and dexamethasone or newly high-dose melphalan supported by peripheral blood stem cell transplantation. This progressive therapy leads to the better survival and prognosis in the majority of patients. Lenalidomide is an oral bioavailable analogue of thalidomide belonging to a class of immunomodulatory drugs. Trials involving thalidomide for the treatment of amyloidosis have shown that, although thalidomide has activity in primary systemic (AL) amyloidosis, it also has high rates of complications and toxic effects. Lenalidomide may be better tolerated and is therefore was investigated for the management of amyloidosis.
Lenalidomide is an oral bioavailable analogue of thalidomide belonging to a class of immunomodulatory drugs. Other therapeutic approaches include thalidomide (alone or in combination with cyclophosphamide), iododoxorubicin, etanercept and rituximab. There are phase II studies that support the use of this drug for amylodosis..
Other therapeutic approaches include thalidomide (alone or in combination with cyclophosphamide), iododoxorubicin, etanercept and rituximab.
Romana Ryšavá. AL Amyloidosis with Renal Involvement Kidney and Blood Pressure Research 2007;30:359-364
Hans P. Sviggum, BA; Mark D. P. Davis, MD; S. Vincent Rajkumar, MD; Angela Dispenzieri, MD Dermatologic Adverse Effects of Lenalidomide Therapy for Amyloidosis and Multiple Myeloma Arch Dermatol. 2006;142:1298-1302.
Sanchorawala, V., Wright, D. G., Rosenzweig, M., Finn, K. T., Fennessey, S., Zeldis, J. B., Skinner, M., Seldin, D. C. (2007). Lenalidomide and dexamethasone in the treatment of AL amyloidosis: results of a phase 2 trial. Blood 109: 492-496