title: Longitudinal bone marrow evaluations for myelodysplasia in patients with myeloma before and after treatment with lenalidomide.
abstract: Lenalidomide (LEN) treatment in multiple myeloma (MM) results in a superior outcome. However, there is concern for increased myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) associated with LEN. Thus, bone marrow morphology and cytogenetics studies from 40 patients were evaluated for early signs of MDS prior to therapy, during therapy and at follow-up. Newly diagnosed patients with MM treated with LEN and dexamethasone (LD) alone or followed by autologous stem cell transplant (LD/ASCT), or patients with relapsed/refractory MM treated with LEN, bendamustine and dexamethasone (BLD) were included. One patient developed MDS. Baseline prevalence of mild morphologic myelodysplasia was highest in pretreated patients with MM (BLD, 71%), but was also seen in newly diagnosed patients (LD and LD/ASCT, 17%). The prevalence of myelodysplasia did not increase over time. Thus, this study did not reveal rapidly emerging MDS in 39 of 40 patients with MM treated with LEN. The development of MDS in one patient suggests that longer follow-up is needed for all.
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. sara.monaghan@utsouthwestern.edu
authors.forename: Sara A
authors.initials: SA
authors.lastname: Monaghan
authors.forename: Lijun
authors.initials: L
authors.lastname: Dai
authors.forename: Markus Y
authors.initials: MY
authors.lastname: Mapara
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Normolle
authors.forename: Susanne M
authors.initials: SM
authors.lastname: Gollin
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lentzsch
mesh_terms: D000368:Aged; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D017404:In Situ Hybridization, Fluorescence; D000077269:Lenalidomide; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D009190:Myelodysplastic Syndromes / Q000209:etiology*; D012189:Retrospective Studies; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide