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Outcome of patients treated for myelodysplastic syndromes without deletion 5q after failure of lenalidomide therapy.
- Source :
-
Oncotarget [Oncotarget] 2017 Jun 06; Vol. 8 (23), pp. 37866-37874. - Publication Year :
- 2017
-
Abstract
- Anemia is a key survival prognostic factor in lower-risk myelodysplastic syndromes (MDS). Lenalidomide (LEN) can correct anemia in 25% of MDS patients without deletion 5q (del5q). As this therapy will inevitably fail, understanding the outcome of these patients will facilitate development of subsequent treatment strategies. To answer this question, an international retrospective study focused on LEN-treated lower-risk, non-del5q, MDS patients was performed. We analyzed the overall survival after LEN failure, its prognostic factors and the impact of post LEN treatment options. We included a total of 384 patients. The median overall survival after failure of LEN was 43 months. In multivariate analysis, adverse cytogenetics, excess of blasts at the initiation of LEN, and the type of failure (classified as stable disease, relapse, intolerance, or progression) were the main determinants of outcome. Subsequent therapy with hypomethylating agents was associated with a prolonged survival compared to BSC (median OS= 51m vs. 36m, p=0.01). In conclusion, the survival for non-del5q MDS patients after failure of LEN remains relatively prolonged, though with a wide range. Clinical trial participation remains the recommendation for these patients even if options such as hypomethylating agents may be considered.
- Subjects :
- Adult
Aged
Aged, 80 and over
Anemia drug therapy
Angiogenesis Inhibitors pharmacology
Chromosome Deletion
Disease Progression
Female
Humans
Lenalidomide
Middle Aged
Myelodysplastic Syndromes genetics
Myelodysplastic Syndromes mortality
Prognosis
Survival Analysis
Thalidomide pharmacology
Thalidomide therapeutic use
Treatment Outcome
Young Adult
Anemia etiology
Angiogenesis Inhibitors therapeutic use
Chromosomes, Human, Pair 5 metabolism
Myelodysplastic Syndromes drug therapy
Thalidomide analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1949-2553
- Volume :
- 8
- Issue :
- 23
- Database :
- MEDLINE
- Journal :
- Oncotarget
- Publication Type :
- Academic Journal
- Accession number :
- 28184031
- Full Text :
- https://doi.org/10.18632/oncotarget.15200