TY - JOUR
T1 - Multivariate time-dependent comparison of the impact of lenalidomide in lower-risk myelodysplastic syndromes with chromosome 5q deletion
AU - Sánchez-García, Joaquín
AU - del Cañizo, Consuelo
AU - Lorenzo, Ignacio
AU - Nomdedeu, Benet
AU - Luño, Elisa
AU - de Paz, Raquel
AU - Xicoy, Blanca
AU - Valcárcel, David
AU - Brunet, Salut
AU - Marco-Betes, Victor
AU - García-Pintos, Marta
AU - Osorio, Santiago
AU - Tormo, Mar
AU - Bailén, Alicia
AU - Cerveró, Carlos
AU - Ramos, Fernando
AU - Diez-Campelo, María
AU - Such, Esperanza
AU - Arrizabalaga, Beatriz
AU - Azaceta, Gemma
AU - Bargay, Joan
AU - Arilla, María J.
AU - Falantes, José
AU - Serrano-López, Josefina
AU - Sanz, Guillermo F.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Summary: 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. © 2014 John Wiley & Sons Ltd.
AB - Summary: 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. © 2014 John Wiley & Sons Ltd.
KW - Deletion 5q
KW - Lenalidomide
KW - Myelodysplastic syndrome
KW - Prognosis
KW - Treatment
U2 - 10.1111/bjh.12876
DO - 10.1111/bjh.12876
M3 - Article
SN - 0007-1048
VL - 166
SP - 189
EP - 201
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 2
ER -