Extended survival and reduced risk of AML progression in erythroid-responsive lenalidomide-treated patients with lower-risk del(5q) MDS

A. F. List, J. M. Bennett, M. A. Sekeres, B. Skikne, T. Fu, J. M. Shammo, S. D. Nimer, R. D. Knight, A. Giagounidis

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Lenalidomide is the approved treatment for patients with red blood cell (RBC) transfusion-dependent lower-risk myelodysplastic syndromes (MDS) and chromosome 5q deletion (del(5q)). We report the long-term outcomes (median follow-up 3.2 years) in patients treated with lenalidomide in the MDS-003 trial. RBC transfusion independence (TI) ≥8 weeks was achieved in 97 of 148 treated patients (65.5%), with a median response duration of 2.2 years. Partial or complete cytogenetic response was achieved by 63 of 88 evaluable patients (71.6%). Median overall survival (OS) was longer in patients achieving RBC-TI ≥8 weeks (4.3 vs 2.0 years in non-responders; P<0.0001) or cytogenetic response (4.9 vs 3.1 years in non-responders; P=0.010). Time to acute myeloid leukemia (AML) progression was longer in patients achieving RBC-TI ≥8 weeks or any cytogenetic response versus non-responders (P=0.001 and P=0.0002, respectively). In a landmark multivariate analysis, RBC-TI ≥8 weeks was associated with prolonged OS (P<0.001) and a trend toward reduced relative risk of AML progression (P=0.080). Among these lower-risk MDS patients with del(5q), lenalidomide was associated with prolonged RBC-TI and cytogenetic responses, which were linked to improved OS and reduced risk of AML progression.

Original languageEnglish (US)
Pages (from-to)1033-1040
Number of pages8
JournalLeukemia
Volume28
Issue number5
DOIs
StatePublished - May 2014
Externally publishedYes

Keywords

  • acute myeloid leukemia
  • del(5q)
  • lenalidomide
  • myelodysplastic syndromes
  • transfusion independence

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

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    List, A. F., Bennett, J. M., Sekeres, M. A., Skikne, B., Fu, T., Shammo, J. M., Nimer, S. D., Knight, R. D., & Giagounidis, A. (2014). Extended survival and reduced risk of AML progression in erythroid-responsive lenalidomide-treated patients with lower-risk del(5q) MDS. Leukemia, 28(5), 1033-1040. https://doi.org/10.1038/leu.2013.305