Journal Article

Clinical characteristics and outcomes according to age in lenalidomide-treated patients with RBC transfusion-dependent lower-risk MDS and del(5q)

Mittelman, Moshe, Skikne, Barry, Powell, Bayard L., Guerci-Bresler, Agnes, List, Alan F., Hellström-Lindberg, Eva, Yu, Xujie, del Cañizo, Consuelo, Fenaux, Pierre, Nimer, Stephen D., Beyne-Rauzy, Odile, Muus, Petra, Sekeres, Mikkael A., Selleslag, Dominik, Greenberg, Peter L., Shammo, Jamile M., Giagounidis, Aristoteles, Deeg, H. Joachim

2017

Overview

Background Particularly since the advent of lenalidomide, lower-risk myelodysplastic syndromes (MDS) patients with del(5q) have been the focus of many studies; however, the impact of age on disease characteristics and response to lenalidomide has not been analyzed. Methods We assessed the effect of age on clinical characteristics and outcomes in 286 lenalidomide-treated MDS patients with del(5q) from two multicenter trials. Results A total of 33.9, 34.3, and 31.8% patients were aged <65 years, ≥65 to <75 years, and ≥75 years, respectively. Age <65 years was associated with less favorable International Prognostic Scoring System (IPSS) risk and additional cytopenias at baseline versus older age groups, significantly lower cytogenetic response rates ( p  = 0.022 vs. ≥65 to <75 years; p  = 0.047 vs. ≥75 years), and higher rates of acute myeloid leukemia (AML) progression (Gray’s test, p  = 0.013). Lenalidomide was equally well tolerated across age groups, producing consistently high rates of red blood cell transfusion independence ≥26 weeks. Conclusions Baseline disease characteristics and AML progression appear to be more severe in younger lower-risk MDS patients with del(5q), whereas older age does not seem to compromise the response to lenalidomide. Trial registration ClinicalTrials.gov NCT00065156 and NCT00179621

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acute myeloid leukemia / Adult / Age / Age Factors / Age groups / Aged / Aged, 80 and over / Blood / Blood transfusion / Cancer Research / Chromosomes, Human, Pair 5 - genetics / Clinical trials / Cytogenetics / del(5q) / Disease Progression / Drug therapy / Erythrocyte Transfusion / Erythrocytes / Female / Geriatrics / Hematology / Humans / Immunologic Factors - therapeutic use / Immunotherapy / Lenalidomide / Leukemia / Leukemia, Myeloid, Acute - etiology / Male / Medical prognosis / Medicine / Medicine & Public Health / Middle Aged / Myelodysplastic syndrome / Myelodysplastic syndromes / Myelodysplastic Syndromes - diagnosis / Myelodysplastic Syndromes - drug therapy / Myelodysplastic Syndromes - genetics / Myelodysplastic Syndromes - pathology / Myeloid leukemia / Oncology / Patient outcomes / Patients / Prognosis / Risk Factors / Studies / Targeted cancer therapy / Thalidomide - analogs & derivatives / Thalidomide - therapeutic use / Treatment Outcome / Working groups