Evaluation of Immune Suppression in Multiple Myeloma Patients Treated with Lenalidomide Plus Prednisone and Lenalidomide Alone.

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MUTHU RAJA Karthick Raja ŘÍHOVÁ Lucie HÁJEK Roman

Year of publication 2012
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description Lenalidomide is one of the immunomodulatory drugs (IMiDs), which function efficiently as immune system modulator and interfere with tumor and its microenvironment via anti-angiogenic, anti-proliferative and anti-inflammatory effects, and also down regulate adhesion molecules in tumor cells. Lenalidomide has significantly improved survival outcome in multiple myeloma (MM) patients. Recently, we and others have shown that lenalidomide in combination with dexamethasone increased the immune suppressor cell numbers in MM patients (Muthu Raja et al, 2012; Minnema et al, 2009). Also, an in vivo study showed that anti-tumor properties of lenalidomide are not compromised by dexamethasone but lenalidomide induced immune modulatory effects are reduced. Here in this study, we aimed to compare the immune suppressor cells and other immune cells in multiple myeloma patients who are treated with lenalidomide plus prednisone (LP) and lenalidomide alone (L). Conclusions: Our study clearly showed that immune suppressor cells including, Tregs and MDSCs were significantly increased in MM patients treated with lenalidomide plus prednisone compared to patients treated with lenalidomide alone. Increase in immune suppressor cells might be due to inclusion of prednisone with lenalidomide. This finding is also further supported by lenalidomide arm data, where no significant increase in immune suppressor cells was observed. Expanded immune suppressor cells in lenalidomide plus prednisone treated cohort might be more susceptible to infectious complications and progression risk.
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