Oncotarget

Research Papers:

Outcome of patients treated for myelodysplastic syndromes with 5q deletion after failure of lenalidomide therapy

Thomas Prebet, Thomas Cluzeau _, Sophie Park, Mikkael A. Sekeres, Ulrich Germing, Lionel Ades, Uwe Platzbecker, Katharina Gotze, Norbert Vey, Esther Oliva, Mary M. Sugrue, Cecile Bally, Charikleia Kelaidi, Najla Al Ali, Pierre Fenaux, Steven D. Gore and Rami Komrokji

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Oncotarget. 2017; 8:81926-81935. https://doi.org/10.18632/oncotarget.18477

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Abstract

Thomas Prebet1, Thomas Cluzeau2,*, Sophie Park3,4,*, Mikkael A. Sekeres5, Ulrich Germing6, Lionel Ades4,7, Uwe Platzbecker8, Katharina Gotze9, Norbert Vey4,10, Esther Oliva11, Mary M. Sugrue12, Cecile Bally4, Charikleia Kelaidi4, Najla Al Ali2, Pierre Fenaux4,7, Steven D. Gore1,* and Rami Komrokji2,*

1 Moffit Cancer Center, Tampa, Florida, USA

2 Cote d’Azur University, Nice Sophia Antipolis University, Centre Hospitalier Universitaire de Nice, Nice, France

3 U1065, Mediterranean Center of Molecular Medecine, Nice, France

4 Groupe Francophone des Myelodysplasies, Hopital Saint Louis, Paris, France

5 Leukemia Program, Cleveland Clinic, Cleveland, OH, USA

6 Department Hematology, Oncology and Clinical Immunology, Heinrich Heine University, Dusseldorf, Germany

7 Service Hematologie Senior, Hopital Saint Louis, Paris, France

8 Universitäts Klinikum Carl Gustav Carus, Dresden, Germany

9 Klinikum Rechts der Isar, Technische Universität München, München, Germany

10 Departement d’Hematologie, Institut Paoli-Calmettes, Marseille, France

11 Hematology Unit, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy

12 Celgene Corporation, Summit, NJ, USA

* These authors have contributed equally to this work

Correspondence to:

Thomas Prebet, email:

Keywords: myelodysplasia, outcome, lenalidomide

Received: April 18, 2017 Accepted: April 24, 2017 Published: June 14, 2017

Abstract

While lenalidomide (LEN) is the standard of care for the lower-risk myelodysplastic syndromes (MDS) patients with deletion 5q, 35% will not respond to or do not tolerate the drug. Moreover, most of the patients will lose their response after a few years. Defining the outcome of patients with LEN failure and determining the impact of subsequent therapies is therefore important to develop alternative strategies. Based on an international collaboration, we were able to compile a total of 392 patient cases of lower-risk MDS patients with 5q deletion and to analyze their outcome after failure of lenalidomide. The median survival following LEN failure was 23 months. We observed a negative impact on survival of advanced age, higher bone marrow blast count at LEN initiation, progression after LEN failure, and unfavorable cytogenetics. Among the treatment strategies, we observed a relatively prolonged survival of patients treated subsequently with hypomethylating agents and only a limited impact on survival of allogeneic transplantation. In conclusion, our work stresses the relatively short survival of this group of patient and defines the expected baseline for the needed future investigations in this group of patients.


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