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Given that a lot of the dose-dependent opposed results happen inside the first few cycles of remedy, initiating therapy at lenalidomide dose of 20 mg or lower with a gradual dose ramp-up in subsequent cycles if tolerated may be appropriate for top-threat patient populations, including these with poor performance standing, advanced age, danger for tumor lysis, and reduced bone marrow reserve.
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25 mg orally once each day for 21 days in combination with dexamethasone 40 mg orally on days 1, eight, 15, and 22. In sufferers who are ineligible for autologous stem-cell transplantation, repeat treatment cycles every 28 days till disease progression.