Practical recommendations on the use of lenalidomide in the management of myelodysplastic syndromes.
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.
Giagounidis
Aristoteles
A
St. Johannes Hospital, Medizinische Klinik II, An der Abtei 7-11, 47166 Duisburg, Germany. gia@krebs-duisburg.de
Fenaux
Pierre
P
Mufti
Ghulam J
GJ
Muus
Petra
P
Platzbecker
Uwe
U
Sanz
Guillermo
G
Cripe
Larry
L
Von Lilienfeld-Toal
Marie
M
Wells
Richard A
RA
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
D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide