Transfusion independence after lenalidomide discontinuation in patients with del(5q) myelodysplastic neoplasm: a HARMONY Alliance study.

Autor: Crisà E; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy. elena.crisa@ircc.it.; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy. elena.crisa@ircc.it., Mora E; Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain., Germing U; Department of Hematology, Oncology and Clinical Immunology, Universitätsklinik Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Bally C; Hématologie clinique, hôpital Necker. Assistance publique hôpitaux de Paris (APHP), Paris, France., Diez Campelo M; Hematology, Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain., Myllymäki M; Hematology Research Unit Helsinki, University of Helsinki and Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland., Jädersten M; Department of Hematology M64 Karolinska University Hospital, Stockholm, Sweden., Komrokji R; Malignant Hematology Department, Moffitt Cancer Center, Tampa, FL, USA., Platzbecker U; Department of Hematology, Cellular Therapy,Hemostaseology and Infectiology, University Hospital Leipzig, Leipzig, Germany., Haase D; Clinics of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany., Hofmann WK; Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Heidelberg, Germany., Al Ali NH; Malignant Hematology Department, Moffitt Cancer Center, Tampa, FL, USA., Barraco D; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; Dipartimento di Ematologia - ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy., Bargay JJ; Hematology Department. Hospital Son Llatzer, Mallorca, Spain., Bernal T; Hematology Department. Hospital Central de Asturias, Oviedo, Spain., López Cadenas F; Hematology Department. Hospital Clinico Universitario de Salamanca, Salamanca, Spain., Calvisi A; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; UOC Ematologia CTMO, Osp San Francesco Nuoro, Nuoro, Italy., Capodanno I; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; SOC Ematologia Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy., Cerrano M; Hematology-University Hospital Città della Salute e della Scienza, Turin, Italy.; Hematology- Hospital Città della Salute e della Scienza, Turin, Italy., Ciancia R; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; IRCCS Centro di Riferimento Oncologico (CRO) di Aviano (Pordenone), Aviano, Italy., Crugnola M; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; Hematology Unit and BMT center University Hospital of Parma, Parma, Italy., Kündgen A; Department of Hematology, Oncology and Clinical Immunology, Universitätsklinik Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany., Finelli C; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Institute of Hematology 'Seràgnoli', Bologna, Italy., Fozza C; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy., Frairia C; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; Hematology- Hospital Città della Salute e della Scienza, Turin, Italy., Freja E; Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland., Ganster C; Clinics of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany., Kubasch AS; Department of Hematology, Cellular Therapy,Hemostaseology and Infectiology, University Hospital Leipzig, Leipzig, Germany., Jimenez MJ; Hematology Department. Hospital Gemans Trias i Pujol, Badalona, Spain., Latagliata R; Unità Operativa Complessa (UOC) Ematologia, Ospedale Belcolle, Viterbo and Division of Cellular Biotechnology and Hematology, Sapienza University, Rome, Italy., Hernandez Mohedo F; Hematology Department. Hopital Unversitario Virgen de las Nieves, Granada, Spain., Molero A; Hematology Department. Hospital Universitario Vall D'Hebron, Barcelona, Spain., Vara Pampliega M; Hematology Department. Hospital de Cruces, Barakaldo, Spain., Perez CA; Hematology Department. Hospital Universitario Reina Sofia, Cordoba, Spain., Pietrantuono G; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; IRCCS CROB, Referral Cancer Center of Basilicata, Rionero In Vulture, Italy., Poloni A; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy.; Hematology, Università Politecnica Marche - AOU Marche, Ancona, Italy., Pomares H; Hematology Department. ICO Duran i Reynals, L'Hospitalet de LLobregat, LLobregat, Spain., Recasens V; Valle Recasens. Hematology Department. Hospital Miguel Servent, Zaragoza, Spain., Rüfer A; Division of Hematology, Luzerner Kantonsspital-in association with University Luzern, Luzern, Switzerland., Signori A; Department of Health Sciences - Section of Biostatistics University of Genoa, Genova, Italy., Hellstrom-Lindberg E; Hematology Research Unit Helsinki, University of Helsinki and Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland., Fenaux P; Service d'Hématologie Séniors, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France., Sanz G; Hematology, Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain.; CIBERONC, ISCIII, Madrid, Spain., Santini V; Fondazione Sindromi Mielodisplastiche FISiM-ETS, Bologna, Italy. valeria.santini@unifi.it.; MDS Unit, Hematology, DMSC, AOU Careggi, University of Florence, Florence, Italy. valeria.santini@unifi.it.
Jazyk: angličtina
Zdroj: Leukemia [Leukemia] 2024 Oct; Vol. 38 (10), pp. 2259-2265. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1038/s41375-024-02360-1
Abstrakt: Lenalidomide (LEN) can induce red blood cell-transfusion independence (RBC-TI) in 60-70% of del(5q) myelodysplastic neoplasm (MDS) patients. Current recommendation is to continue LEN in responding patients until failure or progression, with likelihood of toxicity and a high cost for healthcare systems. This HARMONY Alliance study investigated the outcome of MDS del(5q) patients who discontinued LEN while RBC-transfusion independent. We enrolled 118 patients with IPSS-R low-intermediate risk. Seventy patients (59%) discontinued LEN for intolerance, 38 (32%) per their physician decision, nine (8%) per their own decision and one (1%) for unknown reasons. After a median follow-up of 49 months from discontinuation, 50/118 patients lost RBC-TI and 22/30 who underwent cytogenetic re-evaluation lost complete cytogenetic response. The median RBC-TI duration was 56 months. In multivariate analysis, RBC-TI duration after LEN discontinuation correlated with low transfusion burden before LEN therapy, treatment ≥ 12 LEN cycles, younger age and higher Hb level at LEN withdrawal. Forty-eight patients were re-treated with LEN for loss of response and 28 achieved again RBC-TI. These data show that stopping LEN therapy in MDS del(5q) patients who reached RBC-TI allows prolonged maintenance of TI in a large subset of patients.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
Externí odkaz: