Efficacy of Lenalidomide in Myelodysplastic Syndromes

List, Alan F.; Kurtin, S.; Roe, Denise J.; Buresh, Andrew J.; Mahadevan, Daruka; Fuchs, Deborah; Rimsza, Lisa M.; Heaton, Ruth; Knight, Robert D.; Zeldis, Jerome B.

doi:10.1056/nejmoa041668

Cited by 815 publications

(574 citation statements)

References 28 publications

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“…A separate MDS entity involving only chromosome 5q, and the focus of the actin-sensing mechanism discussed below, is the former 5q-syndrome, now called MDS with isolated del(5q) (herein referred to as ((del)5 or 5q-)) (Vardiman et al, 2009). This syndrome is characterized by interstitial deletions in chromosome 5q (different than those found in AML) and commonly presents as anemia, mild leukopenia and thrombocytosis with a female predominance, and has a more benign clinical course and good response to lenalidomide (List et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

5q– myelodysplastic syndromes: chromosome 5q genes direct a tumor-suppression network sensing actin dynamics

et al. 2009

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Section: Introductionmentioning

confidence: 99%

5q– myelodysplastic syndromes: chromosome 5q genes direct a tumor-suppression network sensing actin dynamics

et al. 2009

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“…12 Clinical trials assessing the efficacy of lenalidomide in MDS showed that this drug can reduce transfusion requirements and reverse cytologic and cytogenetic abnormalities in patients who have MDS with the 5q31 deletion. 13,14 The aim of the present study was to apply the FISH technique in patients diagnosed with MDS in whom cytogenetic analysis had shown a normal karyotype, absence of metaphases or an abnormal karyotype without evidence of del(5q). FISH would allow the detection of the 5q deletion in those cases in which cytogenetic analysis had not found the deletion.…”

Section: Introductionmentioning

confidence: 99%

Fluorescence in situ hybridization improves the detection of 5q31 deletion in myelodysplastic syndromes without cytogenetic evidence of 5q-

Mallo¹,

Arenillas²,

Espinet³

et al. 2008

Haematologica

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BackgroundMore than 50% of patients with myelodysplastic syndromes present cytogenetic aberrations at diagnosis. Partial or complete deletion of the long arm of chromosome 5 is the most frequent abnormality. The aim of this study was to apply fluorescence in situ hybridization of 5q31 in patients diagnosed with de novo myelodysplastic syndromes in whom conventional banding cytogenetics study had shown a normal karyotype, absence of metaphases or an abnormal karyotype without evidence of del(5q). Design and MethodsWe performed fluorescence in situ hybridization of 5q31 in 716 patients, divided into two groups: group A patients (n=637) in whom the 5q deletion had not been detected at diagnosis by conventional banding cytogenetics and group B patients (n=79), in whom cytogenetic analysis had revealed the 5q deletion (positive control group). ResultsIn group A (n=637), the 5q deletion was detected by fluorescence in situ hybridization in 38 cases (5.96%). The majority of positive cases were diagnosed as having the 5q-syndrome. The deletion was mainly observed in cases in which the cytogenetics study had shown no metaphases or an aberrant karyotype with chromosome 5 involved. In group B (n=79), the 5q deletion had been observed by cytogenetics and was confirmed to be present in all cases by fluorescence in situ hybridization of 5q31. ConclusionsFluorescence in situ hybridization of 5q31 detected the 5q deletion in 6% of cases without clear evidence of del(5q) by conventional banding cytogenetics. We suggest that fluorescence in situ hybridization of 5q31 should be performed in cases of a suspected '5q-syndrome' and/or if the cytogenetic study shows no metaphases or an aberrant karyotype with chromosome 5 involved (no 5q-chromosome).

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“…For patients with MDS, the IPSS provides an estimated evaluation of life expectancy and transformation to AML that can vary from a few months to several years, according to the level of risk. 1 Among the current therapeutic options available for patients with lower risk MDS, it has been established that erythropoiesis-stimulating agents (ESAs), [6][7][8][9][10][11][12] immunomodulatory drugs like thalidomide and lenalidomide, [13][14][15][16][17][18][19] and immunosuppressive therapies 20,21 can at least partially restore hematopoiesis and induce transfusion independence in selected patients. However, with the possible exception of younger patients who are candidates for allogeneic stem cell transplantation, [21][22][23] transfusions and chelating therapy remain widely used treatment options for a large number patients.…”

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Azacitidine for the treatment of lower risk myelodysplastic syndromes

Musto

Maurillo

Spagnoli

et al. 2010

Cancer

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BACKGROUND:Azacitidine induces responses and prolongs overall survival compared with conventional care regimens in patients who have high‐risk myelodysplastic syndromes (MDS). However, limited data are available concerning the efficacy and safety of azacitidine in patients who have lower risk MDS.METHODS:The authors retrospectively evaluated 74 patients with International Prognostic Scoring System low‐risk or intermediate 1‐risk MDS, who received azacitidine on a national named patient program. At baseline, 84% of patients were transfusion‐dependent, 57% had received erythropoietin, and 51% were aged >70 years. Azacitidine was administered subcutaneously for 5 days (n = 29 patients), 7 days (n = 43 patients), or 10 days (n = 2 patients) every month at a dose of 75 mg/m2 daily (n = 45 patients) or at a fixed dose of 100 mg daily (n = 29 patients) and for a median of 7 cycles (range, 1‐30 cycles).RESULTS:According to the 2006 International Working Group criteria, overall response rate (ORR) was 45.9%, including complete responses (10.8%), partial responses (9.5%), hematologic improvements (20.3%), and bone marrow complete responses (5.4%). The ORR was 51.6% in 64 patients who completed ≥4 cycles of treatment. The median duration of response was 6 months (range, 1‐30 months). After a median follow‐up of 15 months, 71% of patients remained alive. A survival benefit was observed in responders versus nonresponders (94% vs 54% of patients projected to be alive at 2.5 years, respectively; P < .0014). The most common grade 3 or 4 adverse events were myelosuppression (21.6%) and infection (6.8%).CONCLUSIONS:The current results indicated that azacitidine may be a feasible and effective treatment for patients with lower risk MDS. Cancer 2010. © 2010 American Cancer Society.

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Efficacy of Lenalidomide in Myelodysplastic Syndromes

Abstract: Lenalidomide has hematologic activity in patients with low-risk myelodysplastic syndromes who have no response to erythropoietin or who are unlikely to benefit from conventional therapy.

Cited by 815 publications

References 28 publications

5q– myelodysplastic syndromes: chromosome 5q genes direct a tumor-suppression network sensing actin dynamics

5q– myelodysplastic syndromes: chromosome 5q genes direct a tumor-suppression network sensing actin dynamics

Fluorescence in situ hybridization improves the detection of 5q31 deletion in myelodysplastic syndromes without cytogenetic evidence of 5q-

Azacitidine for the treatment of lower risk myelodysplastic syndromes

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