Lenalidomide
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Hyperbilirubinaemia: case report A 55-year-old man developed hyperbilirubinaemia while receiving lenalidomide for early post-polycythemia vera myelofibrosis. In June 2011, the man was initiated on oral lenalidomide 10mg for 21 days followed by 7 days off (1 cycle). By the second cycle of lenalidomide, an asymptomatic increase in total bilirubin was observed, reaching a maximum of 2.0 mg/dL in cycle 4. During the 7 days off lenalidomide period, the total bilirubin trended toward baseline. Other liver function values stayed within normal limits. The elevations in bilirubin were reproducible on rechallenge with lenalidomide. During subsequent cycles, the total bilirubin increased in a predictable pattern during the 21 days on lenalidomide, returning to baseline level during the 7 days off, with these effects most notable during later cycles. As the man remained asymptomatic, and the total bilirubin level improved while off lenalidomide, it was decided to continue the drug. Author comment: "Given that that [total bilirubin] declines when the patient is not taking lenalidomide and that the bilirubin increases with re-challenge and no other explanations are apparent, we have assigned the case report a Naranjo score of 8, which is consistent with a probable adverse drug reaction". Simondsen KA, et al. Lenalidomide-induced elevated bilirubin. Journal of Oncology Pharmacy Practice 18: 402-405, No. 4, Dec 2012. Available from: URL: 803081830 http://dx.doi.org/10.1177/1078155212439492 - USA
0114-9954/10/1434-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 12 Jan 2013 No. 1434
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