Multivariate time-dependent comparison of the impact of lenalidomide in lower-risk myelodysplastic syndromes with chromosome 5q deletion.
The impact of lenalidomide treatment on long-term outcomes of patients with lower risk myelodysplastic syndromes (MDS) and chromosome 5q deletion (del(5q)) is unclear. This study used time-dependent multivariate methodology to analyse the influence of lenalidomide therapy on overall survival (OS) and acute myeloblastic leukaemia (AML) progression in 215 patients with International Prognostic Scoring System (IPSS) low or intermediate-1 risk and del(5q). There were significant differences in several relevant characteristics at presentation between patients receiving (n = 86) or not receiving lenalidomide (n = 129). The 5-year time-dependent probabilities of OS and progression to AML were 62% and 31% for patients receiving lenalidomide and 42% and 25% for patients not receiving lenalidomide; differences were not statistically significant in multivariate analysis that included all variables independently associated with those outcomes (OS, P = 0·45; risk of AML, P = 0·31, respectively). Achievement of RBC transfusion independency (P = 0·069) or cytogenetic response (P = 0·021) after lenalidomide was associated with longer OS in multivariate analysis. These data clearly show that response to lenalidomide results in a substantial clinical benefit in lower risk MDS patients with del(5q). Lenalidomide treatment does not appear to increase AML risk in this population of patients.
IMIBIC/Reina Sofía University Hospital/University of Córdoba, Córdoba, Spain.
Joaquín
J
Sánchez-García
Consuelo
C
Del Cañizo
Ignacio
I
Lorenzo
Benet
B
Nomdedeu
Elisa
E
Luño
Raquel
R
de Paz
Blanca
B
Xicoy
David
D
Valcárcel
Salut
S
Brunet
Victor
V
Marco-Betes
Marta
M
García-Pintos
Santiago
S
Osorio
Mar
M
Tormo
Alicia
A
Bailén
Carlos
C
Cerveró
Fernando
F
Ramos
María
M
Diez-Campelo
Esperanza
E
Such
Beatriz
B
Arrizabalaga
Gemma
G
Azaceta
Joan
J
Bargay
María J
MJ
Arilla
José
J
Falantes
Josefina
J
Serrano-López
Guillermo F
GF
Sanz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics*; D018450:Disease Progression; D004341:Drug Evaluation / Q000379:methods; D017707:Erythrocyte Transfusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000235:genetics; D011379:Prognosis; D012189:Retrospective Studies; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D000077269:Lenalidomide
deletion 5q; lenalidomide; myelodysplastic syndrome; prognosis; treatment