title: Treatment by Lenalidomide in lower risk myelodysplastic syndrome with 5q deletion--the GFM experience.
abstract: We treated 95 RBC transfusion dependent lower risk MDS with del 5q with Lenalidomide (10mg/day, 3 weeks/4 weeks). Median age was 70.4, median interval from diagnosis 29 months. IPSS was low in 31% and intermediate-1 in 69% patients. Del 5q was isolated, with 1 additional and >1 additional abnormality in 79%, 14%, and 6% patients, respectively. 62 (65%) patients achieved transfusion independence (TI). The only significant factor predicting TI was baseline platelet count >150 G/L and platelet decrease by at least 50% during the first weeks of treatment (p=0.001). Grade III-IV neutropenia and thrombocytopenia were seen in 74% and 37.9% of the cases, respectively, and 3 deaths were attributed to cytopenias. Eight (8%) patients developed deep venous thrombosis (DVT). Platelet decrease by less than 50% predicted a higher risk of DVT. Only 6 patients (6.3%) patients progressed to AML, but median follow-up time was short (18 months). We confirm the high rate of TI with Lenalidomide in lower risk MDS with del 5q. Very close patient monitoring for cytopenias and DVT is mandatory, especially during the first weeks of treatment.
authors.affiliation: Groupe Francophone des Myélodysplasies (GFM), France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Le Bras
authors.forename: Marie
authors.initials: M
authors.lastname: Sebert
authors.forename: Charikleia
authors.initials: C
authors.lastname: Kelaidi
authors.forename: Thierry
authors.initials: T
authors.lastname: Lamy
authors.forename: François
authors.initials: F
authors.lastname: Dreyfus
authors.forename: Jacques
authors.initials: J
authors.lastname: Delaunay
authors.forename: Anne
authors.initials: A
authors.lastname: Banos
authors.forename: Michel
authors.initials: M
authors.lastname: Blanc
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.forename: Aline
authors.initials: A
authors.lastname: Schmidt
authors.forename: Sorin
authors.initials: S
authors.lastname: Visanica
authors.forename: Virginie
authors.initials: V
authors.lastname: Eclache
authors.forename: Pascal
authors.initials: P
authors.lastname: Turlure
authors.forename: Odile
authors.initials: O
authors.lastname: Beyne-Rauzy
authors.forename: Agnès
authors.initials: A
authors.lastname: Guerci
authors.forename: Alain
authors.initials: A
authors.lastname: Delmer
authors.forename: Stéphane
authors.initials: S
authors.lastname: de Botton
authors.forename: Delphine
authors.initials: D
authors.lastname: Rea
authors.forename: Pierre
authors.initials: P
authors.lastname: Fenaux
authors.forename: Lionel
authors.initials: L
authors.lastname: Adès
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics*; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000235:genetics* / Q000628:therapy; D009503:Neutropenia / Q000188:drug therapy / Q000209:etiology; D012307:Risk Factors; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000188:drug therapy / Q000209:etiology; D065227:Transfusion Reaction; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide