title: [Lenalidomide treatment in myelodysplastic syndrome with 5q deletion--Czech MDS group experience].
abstract: Myelodysplastic syndrome (MDS) is a common hematological disease in patients over sixty. Despite intensive research, the therapy of this heterogeneous blood disease is complicated. In recent years, two new therapeutic approaches have been proposed: immunomodulation and demethylation therapy. Immunomodulation therapy with lenalidomide represents a meaningful advance in the treatment of anemic patients, specifically those with 5q- aberrations. As much as 60-70% of patients respond and achieve transfusion independence. We present the initial lenalidomide experience of the Czech MDS group. We analyze Czech MDS register data of 34 (31 female; 3 male; median age 69 years) chronically transfused low risk MDS patients with 5q- aberration treated by lenalidomide. Twenty-seven (79.4%) patients were diagnosed with 5q- syndrome, 5 patients with refractory anemia with multilineage dysplasia, 1 patient with refractory anemia with excess of blasts 1, and 1 patient with myelodysplastic/myeloproliferative unclassified. Response, as represented by achieving complete transfusion independence, was achieved in 91% of patients. A true 5q- syndrome diagnosis in most our patients may be responsible for such a high response rate. Complete cytogenetic response was reached in 15% of patients and partial cytogenetic response in 67%, within a median time of 12 months. TP53 mutation was detected in 15% (3 from 18 tested) and 2 of these patients progressed to higher grade MDS. The majority of patients tolerated lenalidomide very well. Based on this albeit small study, we present our findings of high lenalidomide efficacy as well as the basic principles and problems of lenalidomide therapy.
authors.forename: Anna
authors.initials: A
authors.lastname: Jonášová
authors.forename: Libor
authors.initials: L
authors.lastname: Červinek
authors.forename: Petra
authors.initials: P
authors.lastname: Bělohlávková
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Čermák
authors.forename: Monika
authors.initials: M
authors.lastname: Beličková
authors.forename: Petr
authors.initials: P
authors.lastname: Rohoň
authors.forename: Olga
authors.initials: O
authors.lastname: Černá
authors.forename: Ivana
authors.initials: I
authors.lastname: Hochová
authors.forename: Magda
authors.initials: M
authors.lastname: Šišková
authors.forename: Karla
authors.initials: K
authors.lastname: Kačmářová
authors.forename: Eva
authors.initials: E
authors.lastname: Janoušová
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 / Q000627:therapeutic use; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000235:genetics; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide