A study looking at how often people being treated for myeloma have a very low number of white blood cells

Cancer type:

Blood cancers

Myeloma

Status:

Results

Phase:

Other

This study looked at how often people being treated with lenalidomide and dexamethasone for myeloma have a very low number of white blood cells (neutropenia).

More about this trial

Doctors often treat myeloma with chemotherapy, targeted cancer drugs and steroids. You may have lenalidomide and a steroid called dexamethasone if your myeloma treatment stops working, or your myeloma comes back after treatment. This combination of treatment can cause a low white blood cell count.

The aim of this study was to collect information about people having lenalidomide and dexamethasone to find out:

how many people had a drop in white blood cells
how doctors usually treat it

The research team looked at the medical notes of people having treatment to find this out. This is what’s called an observational study. The people taking part didn’t have different treatment because they were taking part in this study.

Summary of results

This study recruited 198 people with myeloma that had come back after treatment. They all had lenalidomide and dexamethasone.

Side effects caused by treatments are given a grade. This goes from grade 1 (mild) to grade 4 (more severe). In this study, the researchers were looking at people who had a grade 3 or 4 drop in white blood cells (neutropenia).

The results showed that:

62 people (31%) had a low white blood cell count at least once during treatment
half of these people had a low white blood cell count 3 times or more
the drop in white blood cells usually happened about 2 months (8.8 weeks) after starting treatment

Some people were more likely to have a low white blood cell count after treatment, including people:

whose kidneys didn’t work as well as normal
whose myeloma was more advanced
who were generally less fit and well
who had other medical conditions

The research team also looked at changes the doctors made during treatment.

They found that doctors reduced the dose of lenalidomide in 48 people (24%). A drop in white blood cells was the main reason to reduce the dose for only 4 of these people.

Doctors delayed the next dose of lenalidomide in 88 people (44%). A drop in white blood cells was the main reason to delay treatment for only 5 of these people.

They gave 46 people (23%) a growth factor injection to stimulate the growth of new blood cells.

The research team concluded that neutropenia is a common side effect of lenalidomide and dexamethasone. They suggest that work needs to be done to improve recommendations on how to treat it.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item

) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.