The ncdences of neutropena and thrombocy topena amid the sixteen patents wth significant renal mparment were 37.5% and 37.5%, respectvely.the dexamethasone only arm, the ncdences of neutropena and thrombocytopena between these wth ordinary renal functowere 4.3% and 5.5%, respectvely, compared wth 1.5% and five.3% patents wth md renal mparment, 5.9% and 17.6% for moderate renal mparment, and 8.3% and 0% the 12 patents wth significant renal mparment, respectvely.There have been no sgnfcant dfferences the ncdences of thrombotc epsodes lenaldomde plus dexamethasone versus dexamethasone only patents wth md, moderate, or serious renal mparment.a pooled analyss within the MM 009 and MM 010 studes, the ncdence of darrhea was 39% the lenaldomde plus dexamethasone arm compared wth 28% the dexamethasone only arm.
130 Multvarate Regorafenib c-Kit inhibitor analyss located that treatment duratobut not therapy assgnment predcted darrhea.Among a cohort of patents who receved 9 15 months of treatment, the ncdence of darrhea just after adjustment for treatment method duratowas smar for lenaldomde plus dexamethasone versus dexamethasone alone, sug gestng the rsk of sudden darrhea wth long run treatment could be partly attrbutable to dexamethasone, but mportant to note that md to reasonable darrhea s a properly recognzed effect of lenaldomde monotherapy, partcularly wth prolonged use.Being a sngle agent treatment the relapsed or refractory MM settng, lenaldomde s agaassocated wth myelosuppresson.a phase dose escalatostudy of lenaldomde five 50 mg day, neutropena was probably the most commoadverse occasion, wth grade 3 neutropena occurrng 15 of 25 patents and grade 4 neutropena four of 25 patents.
113 Grade three thrombocytopena occurred fve of 25 patents.a phase study evaluatng lenaldomde 30 mg the moment day versus 15 mg twce day, ancreased ncdence of cytopena was noted the twce day group, promptng a as soon as day routine movng forward.107 additional resources an extended phrase comply with uof 15 patents treated ntally wth ether 30 mg after day or 15 mg twce day, wth or wthout the addtoof dexamethasone, probably the most com mograde three or 4 toxcty was neutropena, whch occurred ten patents.108 No grade three or 4 thrombocytopena, anema, perpheral neuropathy, or DVT was reported.a subsequent phase study of 222 patents wth relapsed or refractory MM, just about the most regular grade 3 or 4 toxctes wth sngle agent lenaldomde thirty mg as soon as day gveodays 1 21 of each and every 28 day cycle had been neutropena, thrombocytopena, and anema.
112however, the ncdence of DVT and febre neutropena was lower.Pror to recevng regulatory approval, both thaldomde and lenaldomde were assocated wth VTE ncdences 20%

whecombned wth dexamethasone for use as aoff label remedy for MM.131 a systematc revew of VTE charges, a search from the US FDAs MedWatch system identified reviews of VTE amongst eght lenaldomde handled cancer patents, ncludng 3 recevng asprprophylaxs, two owarfarn, and one particular olow molecular weghtheparns.