Document Detail

Lenalidomide in lower-risk myelodysplastic syndromes with karyotypes other than deletion 5q and refractory to erythropoiesis-stimulating agents.
MedLine Citation:
PMID:  22211483     Owner:  NLM     Status:  Publisher    
Lenalidomide (LEN) has been shown to yield red blood cell (RBC) transfusion independence in about 25% of lower risk myelodysplastic syndromes (MDS) without del(5q), but its efficacy in patients clearly refractory to erythropoiesis-stimulating agents (ESA) is not known. We report on 31 consecutive lower-risk non-del(5q) MDS patients with anaemia refractory to ESA and treated with LEN in a compassionate programme, 20 of whom also received an ESA. An erythroid response was obtained in 15 patients (48%), including 10 of the 27 (37%) previously transfusion-dependent (RBC-TD) patients, who became transfusion-independent (RBC-TI). Nine of the responders relapsed, whereas 6 (40%) were still responding and transfusion-free after 11(+) -31(+)  months. Median response duration was 24 months. The erythroid response rate was lower in refractory cytopenia with multilineage dysplasia (27% vs. 60%) and tended to be higher in patients treated with LEN + ESA (55% vs. 36%). Response duration was significantly longer in responders who obtained RBC-TI and in patients treated with LEN after primary resistance to ESA. The main toxicity of LEN was cytopenias. We confirm that, in a patient population of lower risk MDS without del 5q clearly resistant to ESA, LEN is an interesting second line therapeutic option. Its combination with ESAs in this context warrants prospective studies.
David Sibon; Giovanna Cannas; Fiorenza Baracco; Thomas Prebet; Norbert Vey; Anne Banos; Caroline Besson; Selim Corm; Michel Blanc; Bohrane Slama; Hervé Perrier; Pierre Fenaux; Eric Wattel;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-23
Journal Detail:
Title:  British journal of haematology     Volume:  -     ISSN:  1365-2141     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Hématologie, Centre Hospitalier Lyon Sud, Pierre Bénite Hématologie, Institut Paoli-Calmette, Marseille Hématologie, Centre Hospitalier de la Côte Basque, Bayonne Hématologie, CHU Bicêtre, Le Kremlin Bicêtre Hématologie, Centre Hospitalier, Chambéry Hématologie, Centre Hospitalier, Avignon Hématologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Paris 13 University, Bobigny Oncovirologie et Biothérapies, Centre Léon Bérard, Lyon, France.
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