1. Lenalidomide in patients with red blood cell transfusion-dependent myelodysplastic syndrome and del(5q): a single-centre 'real-world' experience
- Author
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Chiara Pagani, Erika Borlenghi, Annamaria Pelizzari, Daniela Bellotti, Luisa Imberti, Cinzia Lamorgese, Francesca Schieppati, Leonardo Boiocchi, Giuseppe Rossi, Alessandra Sottini, and Elisa Cerqui
- Subjects
Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Population ,Gene Expression ,Antineoplastic Agents ,Comorbidity ,Cytogenetic Response ,Bone Marrow ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,In patient ,education ,Adverse effect ,Lenalidomide ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Myeloid leukemia ,Hematology ,Middle Aged ,Prognosis ,Hematologic Response ,Surgery ,Thalidomide ,Single centre ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Myelodysplastic Syndromes ,Mutation ,Disease Progression ,Chromosomes, Human, Pair 5 ,Female ,Chromosome Deletion ,Tumor Suppressor Protein p53 ,business ,Erythrocyte Transfusion ,medicine.drug ,Follow-Up Studies - Abstract
"Real life" data are needed to complement published trials on the efficacy of lenalidomide in patients with myelodysplastic syndrome (MDS) and del(5q) and on the risk of inducing acute myeloid leukemia (AML) progression. Here, we present results of lenalidomide treatment in a consecutive, population-based series of 21 red blood cell (RBC) transfusion-dependent elderly patients with multiple comorbidities. Of 18 evaluable patients (median follow-up: 22 months), 17 achieved an erythroid hematologic response (HI-E) and 16 an RBC transfusion independence. Cytogenetic response (CyR) rate was 80%, median overall survival was 48 months (range 3-164), and 5-year leukemia-free survival was 84%. Three patients progressed to AML; one, with baseline TP53 mutation, achieved HI-E, partial CyR, and did not progress to AML. Eighteen patients experienced hematological adverse events. Overall, lenalidomide was very effective and well tolerated even in unselected elderly patients with multiple comorbidities and did not appear to increase the risk of AML.
- Published
- 2015