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- Title
Early lenalidomide treatment for low and intermediate-1 International Prognostic Scoring System risk myelodysplastic syndromes with del(5q) before transfusion dependence.
- Authors
Oliva, Esther N.; Lauseker, Michael; Aloe Spiriti, Maria Antonietta; Poloni, Antonella; Cortelezzi, Agostino; Palumbo, Giuseppe A.; Balleari, Enrico; Sanpaolo, Grazia; Volpe, Antonio; Ricco, Alessandra; Ronco, Francesca; Alati, Caterina; D'Errigo, Maria Grazia; Santacaterina, Irene; Kündgen, Andrea; Germing, Ulrich; Latagliata, Roberto
- Abstract
Lenalidomide is approved for the treatment of transfusion-dependent (TD) del(5q) myelodysplastic syndromes (MDS). However, few data are available in patients with transfusion-independent (TI) del(5q) MDS. In the first, observational, part of this 2-part study, we assessed the impact of transfusion dependence on overall survival (OS) and non-leukemic death in untreated del(5q) MDS patients who were TD (n = 136), TI with hemoglobin (Hb) ≥10 mg/dL (n = 88), or TI with Hb <10 mg/dL (n = 96). In the second, interventional, part we assessed the quality-of- life (QoL) benefits and clinical efficacy of lenalidomide (10 mg/day) in 12 patients with TI del(5q) MDS and Hb <10 mg/ dL. In the untreated population, OS was significantly longer in TI than in TD patients (TI [Hb ≥10 g/dL], 108 months; TI [Hb <10 g/dL], 77 months; TD, 44 months). Transfusion dependence also negatively impacted non-leukemic death rates. In the interventional part of the study, baseline Hb levels were found to correlate significantly with physical (R = 0.666, P = 0.035) and fatigue (R = 0.604, P = 0.049) QoL scores. Median physical QoL scores improved significantly after 12 weeks’ treatment with lenalidomide (+12.5; P = 0.020). Evaluable TI patients experienced early increases in Hb levels, and all attained an erythroid response. Our findings suggest that TI patients with moderate anemia may benefit from early treatment with lenalidomide.
- Subjects
MYELODYSPLASTIC syndromes treatment; THALIDOMIDE; BLOOD transfusion; ANEMIA; QUALITY of life; THERAPEUTICS
- Publication
Cancer Medicine, 2015, Vol 4, Issue 12, p1789
- ISSN
2045-7634
- Publication type
Article
- DOI
10.1002/cam4.523