Blood Res.  2021 Jun;56(2):102-108. 10.5045/br.2021.2021086.

Lenalidomide for anemia correction in lower-risk del(5q) myelodysplastic syndrome patients of Asian ethnicity

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
  • 2Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
  • 3Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu Catholic University Hospital, Daegu, Korea
  • 4Division of Hematology-Oncology, Chung-Ang University Hospital, Seoul, Korea
  • 5Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
  • 6National Health Insurance Service Ilsan Hospital, Goyang, Korea
  • 7Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
  • 8Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 9Department of Internal Medicine, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Korea
  • 10Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 11Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
  • 12Division of Oncology and Hematology, Department of Internal Medicine, Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju, Korea
  • 13Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University Hospital, Chuncheon, Korea
  • 14Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
  • 15Division of Hematology-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
  • 16Division of Hematology-Oncology, Department of Internal Medicine, Dong-A University College of Medicine, Dong-A University Hospital, Busan, Korea
  • 17Division of Hematology-Oncology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
  • 18Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
  • 19Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
  • 20Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 21University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Abstract

Background
To estimate real-world outcomes in East Asian populations, we conducted a nationwide retrospective analysis of the efficacy and safety of lenalidomide for del(5q) myelodysplastic syndrome (MDS) patients with transfusion-dependent anemia in Korea.
Methods
Patients aged ≥19 years who had received lenalidomide for the treatment of lower-risk, red blood cell (RBC) transfusion-dependent del(5q) MDS were selected. A filled case report form (CRF) with information from electronic medical records was requested from members of the acute myeloid leukemia (AML)/MDS Working Party of the Korean Society of Hematology. All the CRFs were gathered and analyzed.
Results
A total of 31 patients were included in this study. Of 28 evaluable patients, 19 (67.9%) achieved RBC transfusion independence (RBC-TI). Female sex and the development of thrombocytopenia during treatment were associated with achieving RBC-TI. The most common non-hematologic toxicities were pruritus, fatigue, and rashes. All non-hematologic toxicities of grades ≥3 were limited to rash (12.9%) and pruritus (6.5%). Dose reduction was required in 15 of the 19 responders (78.9%). The most common final stable dosing schedule for the responders was 5 mg once every other day (31.6%).
Conclusion
Lenalidomide efficacy and tolerability were similar in the Asian del(5q) MDS patients and western patients. Dose reduction during treatment was common, but it was not associated with inferior outcomes.

Keyword

5q deletion syndrome; Myelodysplastic syndrome; Lenalidomide; Anemia
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