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Polish experience of lenalidomide in the treatment of lower risk myelodysplastic syndrome with isolated del(5q).

Butrym A, Lech-Maranda E, Patkowska E, Kumiega B, Bieniaszewska M, Mital A, Madry K, Torosian T, Wichary R, Rybka J, Warzocha K, Mazur G - BMC Cancer (2015)

Bottom Line: Treatment was well tolerated.A Kaplan-Meier estimate for overall survival at 5 years in the study group was 79.0 ± 8.8 %.Lenalidomide in this group of patients was beneficial for the treatment of RBC transfusion-dependency with well-known safety profile.

View Article: PubMed Central - PubMed

Affiliation: Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland. aleksandra.butrym@gmail.com.

ABSTRACT

Background: Lenalidomide has been approved for the treatment of lower-risk myelodysplastic syndrome (MDS) with 5q deletion (del(5q)). We present for the first time a retrospective analysis of low-risk MDS with isolated del5q treated with lenalidomide, outside the clinical trials.

Methods: 36 red blood cell (RBC) transfusion-dependent patients have been included in the study. Patients received lenalidomide 10 mg/day on days 1-21 of 28-day cycles.

Results: 91.7 % of patients responded to lenalidomide treatment: 72.2 % achieved erythroid response, 19.4 % achieved minor erythroid response and 8.4 % of patients did not respond to treatment. Response depended on number of previous treatment lines (p = 0.0101), International Prognostic System Score (IPSS; p = 0.0067) and RBC transfusion frequency (p = 0.0139). Median duration of response was 16 months (range 6-60 months). Treatment was well tolerated. We observed hematological toxicity (grade 3 and 4): neutropenia in 16 (44.4 %) patients and thrombocytopenia in 9 (25 %) patients. Two patients (5.5 %) progressed to high-risk MDS and two subsequent progressed to acute myeloid leukemia. A Kaplan-Meier estimate for overall survival at 5 years in the study group was 79.0 ± 8.8 %.

Conclusions: Lenalidomide in this group of patients was beneficial for the treatment of RBC transfusion-dependency with well-known safety profile.

No MeSH data available.


Related in: MedlinePlus

Kapplan-Meier estimate for patients' overall survival proportion
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Fig1: Kapplan-Meier estimate for patients' overall survival proportion

Mentions: In the study group, a Kaplan-Meier estimate for overall survival at 5 years was 79.0 ± 8.8 % Fig. 1. In multivariate analysis ferritin level was the only independent prognostic factor for longer OS in lenalidomide treated population (p = 0.01). In study population, five deaths were seen: one due to infection (during therapy), two deaths due to progression into AML (Acute myeloid leukemia), one due to progression into high-risk MDS and 2 due to unknown reasons. In those patients lenalidomide was stopped before death. Median leukemia free survival was 30 months (range 3–92). Patients' median follow-up was 58 months.Fig. 1


Polish experience of lenalidomide in the treatment of lower risk myelodysplastic syndrome with isolated del(5q).

Butrym A, Lech-Maranda E, Patkowska E, Kumiega B, Bieniaszewska M, Mital A, Madry K, Torosian T, Wichary R, Rybka J, Warzocha K, Mazur G - BMC Cancer (2015)

Kapplan-Meier estimate for patients' overall survival proportion
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4495845&req=5

Fig1: Kapplan-Meier estimate for patients' overall survival proportion
Mentions: In the study group, a Kaplan-Meier estimate for overall survival at 5 years was 79.0 ± 8.8 % Fig. 1. In multivariate analysis ferritin level was the only independent prognostic factor for longer OS in lenalidomide treated population (p = 0.01). In study population, five deaths were seen: one due to infection (during therapy), two deaths due to progression into AML (Acute myeloid leukemia), one due to progression into high-risk MDS and 2 due to unknown reasons. In those patients lenalidomide was stopped before death. Median leukemia free survival was 30 months (range 3–92). Patients' median follow-up was 58 months.Fig. 1

Bottom Line: Treatment was well tolerated.A Kaplan-Meier estimate for overall survival at 5 years in the study group was 79.0 ± 8.8 %.Lenalidomide in this group of patients was beneficial for the treatment of RBC transfusion-dependency with well-known safety profile.

View Article: PubMed Central - PubMed

Affiliation: Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland. aleksandra.butrym@gmail.com.

ABSTRACT

Background: Lenalidomide has been approved for the treatment of lower-risk myelodysplastic syndrome (MDS) with 5q deletion (del(5q)). We present for the first time a retrospective analysis of low-risk MDS with isolated del5q treated with lenalidomide, outside the clinical trials.

Methods: 36 red blood cell (RBC) transfusion-dependent patients have been included in the study. Patients received lenalidomide 10 mg/day on days 1-21 of 28-day cycles.

Results: 91.7 % of patients responded to lenalidomide treatment: 72.2 % achieved erythroid response, 19.4 % achieved minor erythroid response and 8.4 % of patients did not respond to treatment. Response depended on number of previous treatment lines (p = 0.0101), International Prognostic System Score (IPSS; p = 0.0067) and RBC transfusion frequency (p = 0.0139). Median duration of response was 16 months (range 6-60 months). Treatment was well tolerated. We observed hematological toxicity (grade 3 and 4): neutropenia in 16 (44.4 %) patients and thrombocytopenia in 9 (25 %) patients. Two patients (5.5 %) progressed to high-risk MDS and two subsequent progressed to acute myeloid leukemia. A Kaplan-Meier estimate for overall survival at 5 years in the study group was 79.0 ± 8.8 %.

Conclusions: Lenalidomide in this group of patients was beneficial for the treatment of RBC transfusion-dependency with well-known safety profile.

No MeSH data available.


Related in: MedlinePlus