A study of high-dose lenalidomide induction and low-dose lenalidomide maintenance therapy for patients with hypomethylating agent refractory myelodysplastic syndrome

Mathew A. Cherian, Raoul Tibes, Feng Gao, Theresa Fletcher, Mark Fiala, Geoffrey L. Uy, Peter Westervelt, Meagan A. Jacoby, Amanda F. Cashen, Keith Stockerl-Goldstein, John F. DiPersio, Ravi Vij

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by bone marrow failure which frequently progress to acute myeloid leukemia. Patients who fail to respond to, or progress on first-line DNA hypomethylating agents (HMA) have a poor prognosis. Conventionally dosed lenalidomide has activity in 5q-MDS. In other subtypes, it may reduce RBC transfusion requirements but does not result in cytogenetic responses. We previously reported that high-dose lenalidomide induction (50 mg/day) results in complete remissions in a high fraction of patients. We, therefore, conducted a Phase 2 trial of the same regimen in MDS refractory to HMA. Marrow complete remissions were seen in 33% of patients and hematological improvement in 8% of patients. Significant infections complicated more than 50% of cases. Future trials to explore alternative dosing schedules of high-dose lenalidomide to increase efficacy while decreasing toxicity are warranted.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Apr 27 2016

Keywords

  • Chemotherapeutic approaches
  • myeloid leukemias and dysplasias
  • pharmacotherapeutics

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Cherian, M. A., Tibes, R., Gao, F., Fletcher, T., Fiala, M., Uy, G. L., Westervelt, P., Jacoby, M. A., Cashen, A. F., Stockerl-Goldstein, K., DiPersio, J. F., & Vij, R. (Accepted/In press). A study of high-dose lenalidomide induction and low-dose lenalidomide maintenance therapy for patients with hypomethylating agent refractory myelodysplastic syndrome. Leukemia and Lymphoma, 1-6. https://doi.org/10.3109/10428194.2016.1173213