Patient findings before and after lenalidomide therapy
| Patient's parameters . | Activities of daily living . | |
|---|---|---|
| Before lenalidomide† . | After 9 cycles‡ . | |
| Karnofsky score | 40 | 70 |
| Hypertrichosis | Present | Improved |
| Hyperpigmentation | Present | Improved |
| Edema | ++++ | Trace |
| Gynecomastia | Present | Improved |
| Neuropathy impairment score* | 121 | 113 |
| C-reactive protein, mg/dL | 0.4 | <0.3 |
| Gamma globulin, g/L | 31 | 20 |
| IgG, g/L | 31.6 | 17.8 |
| Kappa, mg/L | 145 | 42.6 |
| Lambda, mg/L | 177 | 82.4 |
| K/L ratio | 0.82 | 0.52 |
| Monoclonal protein | IgG lambda by immunofixation | IgG lambda by immunofixation |
| Bone marrow plasma cells, % | 5% (monoclonal lambda) | 10% (polyclonal) |
| Cytogenetics | t(9;17)(q22;q25) | No abn by FISH or metaphase |
| VEGF, pg/mL | 948 | 303 |
| IL-6, pg/mL | 140.1 | 6.6 |
| Testosterone, total, ng/dL | 276 | 424 |
| Testosterone, bioavailable, ng/dL | 17 | 36 |
| Urine total protein, mg/24 h | 427 | 158 |
| Pulmonary function | ||
| FVC, % predicted | 75 | 81 |
| FEV-1, % predicted | 70 | 79 |
| PImax, % predicted | 47 | 75 |
| PEmax, % predicted | 25 | 49 |
| Patient's parameters . | Activities of daily living . | |
|---|---|---|
| Before lenalidomide† . | After 9 cycles‡ . | |
| Karnofsky score | 40 | 70 |
| Hypertrichosis | Present | Improved |
| Hyperpigmentation | Present | Improved |
| Edema | ++++ | Trace |
| Gynecomastia | Present | Improved |
| Neuropathy impairment score* | 121 | 113 |
| C-reactive protein, mg/dL | 0.4 | <0.3 |
| Gamma globulin, g/L | 31 | 20 |
| IgG, g/L | 31.6 | 17.8 |
| Kappa, mg/L | 145 | 42.6 |
| Lambda, mg/L | 177 | 82.4 |
| K/L ratio | 0.82 | 0.52 |
| Monoclonal protein | IgG lambda by immunofixation | IgG lambda by immunofixation |
| Bone marrow plasma cells, % | 5% (monoclonal lambda) | 10% (polyclonal) |
| Cytogenetics | t(9;17)(q22;q25) | No abn by FISH or metaphase |
| VEGF, pg/mL | 948 | 303 |
| IL-6, pg/mL | 140.1 | 6.6 |
| Testosterone, total, ng/dL | 276 | 424 |
| Testosterone, bioavailable, ng/dL | 17 | 36 |
| Urine total protein, mg/24 h | 427 | 158 |
| Pulmonary function | ||
| FVC, % predicted | 75 | 81 |
| FEV-1, % predicted | 70 | 79 |
| PImax, % predicted | 47 | 75 |
| PEmax, % predicted | 25 | 49 |
Normal values: VEGF < 83 pg/mL; IL-6 < 5 pg/mL; total testosterone, 240–950 ng/dL; bioavailable testosterone, 61–213 ng/dL.
FISH indicates fluorescent in situ hybridization; AFO, ankle foot orthotic; FVC, forced vital capacity; FEV-1, forced expiratory volume of 1 second; PEmax, maximal exploratory pressure; PImax, maximum inspiratory pressure; and ++++, high level of edema.
The lower the number, the better the function.
Barely able to roll over in bed; unable to bathe, dress, or transfer himself; transportation restricted to wheelchair.
Capable of all ADLs except pulling on support hose; walks with AFOs and walker with ease.