title: Polish experience of lenalidomide in the treatment of lower risk myelodysplastic syndrome with isolated del(5q).
abstract: BACKGROUND
  Lenalidomide has been approved for the treatment of lower-risk myelodysplastic syndrome (MDS) with 5q deletion (del(5q)). We present for the first time a retrospective analysis of low-risk MDS with isolated del5q treated with lenalidomide, outside the clinical trials.
  
  
  METHODS
  36 red blood cell (RBC) transfusion-dependent patients have been included in the study. Patients received lenalidomide 10 mg/day on days 1-21 of 28-day cycles.
  
  
  RESULTS
  91.7 % of patients responded to lenalidomide treatment: 72.2 % achieved erythroid response, 19.4 % achieved minor erythroid response and 8.4 % of patients did not respond to treatment. Response depended on number of previous treatment lines (p = 0.0101), International Prognostic System Score (IPSS; p = 0.0067) and RBC transfusion frequency (p = 0.0139). Median duration of response was 16 months (range 6-60 months). Treatment was well tolerated. We observed hematological toxicity (grade 3 and 4): neutropenia in 16 (44.4 %) patients and thrombocytopenia in 9 (25 %) patients. Two patients (5.5 %) progressed to high-risk MDS and two subsequent progressed to acute myeloid leukemia. A Kaplan-Meier estimate for overall survival at 5 years in the study group was 79.0 ± 8.8 %.
  
  
  CONCLUSIONS
  Lenalidomide in this group of patients was beneficial for the treatment of RBC transfusion-dependency with well-known safety profile.
authors.affiliation: Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland. aleksandra.butrym@gmail.com.|Department of Physiology, Wroclaw Medical University, Wroclaw, Poland. aleksandra.butrym@gmail.com.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Butrym
authors.affiliation: Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. ewamaranda@wp.pl.|Centre of Postgraduate Medical Education, Warsaw, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. ewamaranda@wp.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Lech-Maranda
authors.affiliation: Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. epatkowska@ihit.waw.pl.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Patkowska
authors.affiliation: Department of Oncological Hematology, Carpathian Oncology Centre, Brzozow, Poland. kumiegab@gmail.com.
authors.forename: Beata
authors.initials: B
authors.lastname: Kumiega
authors.affiliation: Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland. mbienia@gumed.edu.pl.
authors.forename: Maria
authors.initials: M
authors.lastname: Bieniaszewska
authors.affiliation: Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland. amital@wp.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Mital
authors.affiliation: Department of Hematology, Warsaw Medical University, Warsaw, Poland. kmadry@wum.edu.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Madry
authors.affiliation: Department of Hematology, Warsaw Medical University, Warsaw, Poland. torosian07@gmail.com.
authors.forename: Tigran
authors.initials: T
authors.lastname: Torosian
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland. dickv@poczta.onet.pl.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Wichary
authors.affiliation: Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland. rybka.justyna@o2.pl.
authors.forename: Justyna
authors.initials: J
authors.lastname: Rybka
authors.affiliation: Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland. sekihit@ihit.waw.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Warzocha
authors.affiliation: Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland. grzegorzmaz@yahoo.com.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Mazur
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D011044:Poland; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide