Memory loss during lenalidomide treatment: a report on two cases

Adeline Rollin-Sillaire,Thierry Facon,Emilie Le Rhun,Marianne Pollet,Pierre Lenfant,Xavier Delbeuck,Florence Pasquier,Xavier Leleu,Marie-Pierre Noel,Marie-Anne Mackowiak

doi:10.1186/2050-6511-14-41

Abstract

BackgroundThere are many reports of cognitive dysfunction in patients receiving chemotherapy or targeted therapies. Many antineoplastic agents may be involved in the condition also known as “chemo brain” or “chemo fog”.Case presentationTwo male patients (aged 41 and 70) with multiple myeloma developed severe, rapidly progressing cognitive impairment (mostly involving episodic memory) and loss of independence in activities of daily living during lenalidomide-based treatment. On withdrawal of the drug, one patient recovered normal cognitive function and independence in activities of daily living, whereas mild cognitive impairment persisted in the other patient. The Naranjo Adverse Drug Reaction Probability Scale score was 6 out of 13 for the first patient and 5 out of 13 for the second, suggesting a probable causal relationship between the adverse event and lenalidomide administration.ConclusionLenalidomide may induce particular cognitive disorders (notably episodic memory impairments) in some patients. The drug’s putative neurotoxicity is probably promoted by specific risk factors (such as previous chemotherapy, prior mild cognitive impairment, age and the presence of cerebrovascular lesions).

Highlights

There are many reports of cognitive dysfunction in patients receiving chemotherapy or targeted therapies
The most frequently reported adverse event (AE) for lenalidomide is immunosuppression, the drug is considered as having a predictable safety profile and manageable effects
Here, we reported on the potential negative impact of lenalidomide on episodic memory in two MM patients undergoing chemotherapy

Summary

Conclusion

We reported on the potential negative impact of lenalidomide on episodic memory in two MM patients undergoing chemotherapy. The symptoms were reversible, they were severe enough to lead to a loss of independence in ADL. The mechanism of these specific cognitive deficits is unknown. Competing interests XL received grant support, lecture fees and board honoraria from Celgene. XD and MP performed neuropsychological examination and revised the draft. MAM, MPN, XL provided patient care and revised the draft. FP revised the draft and has given final approval of the version to be published. EL provided patient care, revised the draft and has given final approval of the version to be published.

Background

Discussion

Findings

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