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

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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.
 

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Williams

Supported by

Amgen

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Last review date

CRUK internal database number:

8194

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Cara took part in a clinical trial

A picture of Cara

"I am glad that taking part in a trial might help others on their own cancer journey.”

Last reviewed:

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