title: Practical recommendations on the use of lenalidomide in the management of myelodysplastic syndromes.
abstract: Lenalidomide, an oral immunomodulatory agent, has received approval in the USA from the Food and Drug Administration (FDA) for the management of myelodysplastic syndromes (MDS) classified by the International Prognostic Scoring System (IPSS) as low risk or intermediate-1 risk and with a deletion 5q (del(5q)) cytogenetic abnormality. Although some patients with del(5q) have a relatively good prognosis, all del(5q) patients will become transfusion-dependent at some point during the course of their disease. The results of two clinical trials in more than 160 patients with MDS have demonstrated clear therapeutic benefits of lenalidomide, with >60% of patients achieving independence from transfusion during therapy, irrespective of age, prior therapy, sex, or disease-risk assessment. The recommendations presented in this review will aid the safe administration of lenalidomide for the treatment of patients with low-risk or intermediate-1-risk MDS and a del(5q) cytogenetic abnormality, and they will help physicians avoid unnecessary dose reduction or interruption, thus assuring the best efficacy for patients.
authors.affiliation: St. Johannes Hospital, Medizinische Klinik II, An der Abtei 7-11, 47166 Duisburg, Germany. gia@krebs-duisburg.de
authors.forename: Aristoteles
authors.initials: A
authors.lastname: Giagounidis
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Ghulam J
authors.initials: GJ
authors.lastname: Mufti
authors.forename: Petra
authors.initials: P
authors.lastname: Muus
authors.forename: Uwe
authors.initials: U
authors.lastname: Platzbecker
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
authors.forename: Larry
authors.initials: L
authors.lastname: Cripe
authors.forename: Marie
authors.initials: M
authors.lastname: Von Lilienfeld-Toal
authors.forename: Richard A
authors.initials: RA
authors.lastname: Wells
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics; D002986:Clinical Trials as Topic; D006801:Humans; D000077269:Lenalidomide; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000235:genetics; D017410:Practice Guidelines as Topic; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide