Lenalidomide treatment in lower risk myelodysplastic syndromes—The experience of a Czech hematology center. (Positive effect of erythropoietin ± prednisone addition to lenalidomide in refractory or relapsed patients)

Identification of Lenalidomide Sensitivity and Resistance Mechanisms in Non-Del(5q) Myelodysplastic Syndromes

“…Some groups have examined lenalidomide treatment response in association with somatic genomic abnormalities and found no link [13]. While other groups have identified unmutated TP53 associated with hematological improvement in del(5q) MDS patients treated with lenalidomide [14,15]. However, in that study, 16% of del(5q) MDS patients with wild type TP53 progressed to AML despite lenalidomide treatment, which indicates that there are additional factors besides this single genetic biomarker involved in lenalidomide response.…”

Introductory Chapter: Progress in Myelodysplastic Syndrome Area

“…After failure of ESAs, lenalidomide yields red blood cell transfusion independence in 20-30% of lower risk non-del(5q) MDS. Indeed, several observations suggest an additive effect of ESA and lenalidomide in this situation [65,66] and also in del(5q) MDS patients [67]. Synthetic corticosteroids (dexamethasone and prednisone) are also able to potentiate the effect of lenalidomide or combination of lenalidomide and erythropoietin [67][68][69].…”