Treatment by Lenalidomide in lower risk myelodysplastic syndrome with 5q deletion-The GFM experience

Fabien Le Bras, Marie Sebert, Charikleia Kelaidi, Thierry Lamy, François Dreyfus, Jacques Delaunay, Anne Banos, Michel Blanc, Norbert Vey, Aline Schmidt, Sorin Visanica, Virginie Eclache, Pascal Turlure, Odile Beyne-Rauzy, Agnès Guerci, Alain Delmer, Stéphane de Botton, Delphine Rea, Pierre Fenaux, Lionel Adès

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    Abstract

    We treated 95 RBC transfusion dependent lower risk MDS with del 5q with Lenalidomide (10 mg/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.

    Original languageEnglish
    Pages (from-to)1444-1448
    Number of pages5
    JournalLeukemia Research
    Volume35
    Issue number11
    DOIs
    Publication statusPublished - 1 Nov 2011

    Keywords

    • Del 5q syndrome
    • Lenalidomide
    • Myelodysplasia

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