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Efficacy of the association of lenalidomide to erythropoiesis-stimulating agents in del (5q) MDS patients refractory to single-agent lenalidomide

Leukemia volume 24, pages 1960–1962 (2010)Cite this article

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Lenalidomide treatment has been approved by Food and Drug Administration for patients with transfusion-dependent anemia due to low and int-1 myelodysplastic syndrome associated with 5q deletion with or without additional cytogenetic abnormalities.1, 2, 3 Erythroid response to lenalidomide is associated with meaningful increases in hemoglobin (Hb), red blood cell transfusion independence, cytogenetic response and probably overall survival.1, 2, 3, 4 Lenalidomide is effective regardless of previous epoetin or thalidomide treatment. Whereas erythroid responses occurred in 83% of patients with 5q deletion, responses were also achieved in patients with a normal karyotype (57%) and with other cytogenetic abnormalities (12%).1, 2, 3

Wei et al.5 previously reported that lenalidomide acts to relieve suppression of the epoetin-receptor signal in myelodysplastic syndrome erythroid precursors, suggesting that the erythropoietic activity of lenalidomide might be improved by combined treatment with erythropoiesis-stimulating agent (ESA). Lenalidomide has also a direct cytotoxicity against 5q− positive cells.5 Recently, in transfusion-dependent myelodysplastic syndrome patients, resistant to lenalidomide alone, the combination lenalidomide+ESA induced 25% of erythroid response (preliminary results).6 To evaluate the potential benefit of the combination of lenalidomide and ESA, we tried the association in three del5q myelodysplastic syndrome patients, who were resistant or partially responding to lenalidomide alone.

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Authors and Affiliations

  1. Department of hematology, Hôpital COCHIN, University of Paris V, Paris, France

    S Park, D Vassilieff & F Dreyfus

  2. Laboratory of hematology, Hôpital COCHIN, University of Paris V, Paris, France

    V Bardet

  3. Laboratory of hematology, Hôpital Hôtel Dieu, University of Paris V, Paris, France

    F Viguié

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  1. S Park
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Correspondence to S Park.

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Park, S., Vassilieff, D., Bardet, V. et al. Efficacy of the association of lenalidomide to erythropoiesis-stimulating agents in del (5q) MDS patients refractory to single-agent lenalidomide. Leukemia 24, 1960–1962 (2010). https://doi.org/10.1038/leu.2010.183

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