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Combination of Azacitidine and Lenalidomide in Myelodysplastic Syndromes or acute Myeloid Leukemia—a wise Liaison?

Leukemia volume 27, pages 1813–1819 (2013)Cite this article

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Abstract

Treatment options for older patients with advanced myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) are limited and the prognosis remains poor, thereby warranting development of novel therapies. Aberrant epigenetic modifications, including altered DNA methylation, seem to contribute to the pathogenesis of these patients. In fact, hypomethylating agents (HMA) like azacitidine have been successfully used in clinical trials and achieved approval from health authorities. There is now growing evidence suggesting that the combination of drugs with different mechanisms of action might offer a potential benefit to these patients. This is especially done with the intention to synergize the positive effects of each drug on the defective hematopoiesis while sparing potential side effects and toxicities. Combination of HMA with histone deacetylase inhibitors, although mechanistically very tempting, have not yielded convincing improvement of the results in the majority of trials compared to single agent HMA treatment. Currently, combination therapies of azacitidine with lenalidomide appear to be promising thus making them an appealing option for treatment in these patients.

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Acknowledgements

We thank S Helas for assistance in formatting the figures and to S Faber from EMSCO (www.emsco.eu) for critically reading the manuscript.

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  1. Medical Clinic I, University Hospital, Technical University, Dresden, Germany

    U Platzbecker

  2. German MDS Study Group,

    U Platzbecker & U Germing

  3. Department of Hematology, Oncology and Clinical Immunology, University Hospital, Heinrich Heine University, Düsseldorf, Germany

    U Germing

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UP and UG have received speakers honoraria and research support from Celgene Corporation. UP is supported by a grant within the SFB 655 from the Deutsche Forschungsgemeinschaft (DFG).

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UP designed the study, collected analyzed and interpreted data, and wrote the manuscript. UG interpreted data and edited the paper.

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Platzbecker, U., Germing, U. Combination of Azacitidine and Lenalidomide in Myelodysplastic Syndromes or acute Myeloid Leukemia—a wise Liaison?. Leukemia 27, 1813–1819 (2013). https://doi.org/10.1038/leu.2013.140

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