Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses

Lenalidomide has particular activity in patients with transfusion-dependent del(5q) myelodysplastic syndromes (MDS), but mechanistic information is limited regarding the relationship between erythroid and cytogenetic responses. We reviewed medical records from three distinct subgroups of del(5q) MDS...

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Main Authors:	Giagounidis, Aristoteles A. N., Haase, Sabine, Heinsch, Michael, Göhring, Gudrun, Schlegelberger, Brigitte, Aul, Carlo
Format:	Online
Language:	English
Published:	Springer-Verlag 2006
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1705486/

id	pubmed-1705486
recordtype	oai_dc
spelling	pubmed-17054862006-12-18 Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses Giagounidis, Aristoteles A. N. Haase, Sabine Heinsch, Michael Göhring, Gudrun Schlegelberger, Brigitte Aul, Carlo Original Article Lenalidomide has particular activity in patients with transfusion-dependent del(5q) myelodysplastic syndromes (MDS), but mechanistic information is limited regarding the relationship between erythroid and cytogenetic responses. We reviewed medical records from three distinct subgroups of del(5q) MDS patients who had unexpected effects with lenalidomide treatment: 1. two patients with complex karyotypes who achieved both cytogenetic remissions and transfusion independence; 2. two patients with 5q- syndrome who took lenalidomide for less than 12 weeks but remained transfusion independent for 15+ months still displaying del(5q) metaphases after 6 and 12 months; and 3. one patient who was a non-responder on lenalidomide during treatment but became transfusion independent for 13+ months after discontinuation. All but the latter patient in this series had reduction of affected metaphases, suggesting that erythroid responses might be mediated by result from partial or complete suppression of the malignant clone, either directly or indirectly through modulation of the bone marrow microenvironment. These clinical observations illustrate the heterogeneity of del(5q)MDS pathogenesis and the diversity of lenalidomide responses within this patient subset. Springer-Verlag 2006-11-17 2007-02 /pmc/articles/PMC1705486/ /pubmed/17111142 http://dx.doi.org/10.1007/s00277-006-0217-y Text en © Springer-Verlag 2006
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Giagounidis, Aristoteles A. N. Haase, Sabine Heinsch, Michael Göhring, Gudrun Schlegelberger, Brigitte Aul, Carlo
spellingShingle	Giagounidis, Aristoteles A. N. Haase, Sabine Heinsch, Michael Göhring, Gudrun Schlegelberger, Brigitte Aul, Carlo Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses
author_facet	Giagounidis, Aristoteles A. N. Haase, Sabine Heinsch, Michael Göhring, Gudrun Schlegelberger, Brigitte Aul, Carlo
author_sort	Giagounidis, Aristoteles A. N.
title	Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses
title_short	Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses
title_full	Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses
title_fullStr	Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses
title_full_unstemmed	Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses
title_sort	lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)mds patients with unexpected responses
description	Lenalidomide has particular activity in patients with transfusion-dependent del(5q) myelodysplastic syndromes (MDS), but mechanistic information is limited regarding the relationship between erythroid and cytogenetic responses. We reviewed medical records from three distinct subgroups of del(5q) MDS patients who had unexpected effects with lenalidomide treatment: 1. two patients with complex karyotypes who achieved both cytogenetic remissions and transfusion independence; 2. two patients with 5q- syndrome who took lenalidomide for less than 12 weeks but remained transfusion independent for 15+ months still displaying del(5q) metaphases after 6 and 12 months; and 3. one patient who was a non-responder on lenalidomide during treatment but became transfusion independent for 13+ months after discontinuation. All but the latter patient in this series had reduction of affected metaphases, suggesting that erythroid responses might be mediated by result from partial or complete suppression of the malignant clone, either directly or indirectly through modulation of the bone marrow microenvironment. These clinical observations illustrate the heterogeneity of del(5q)MDS pathogenesis and the diversity of lenalidomide responses within this patient subset.
publisher	Springer-Verlag
publishDate	2006
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1705486/
_version_	1611392069488607232

Lenalidomide in the context of complex karyotype or interrupted treatment: case reviews of del(5q)MDS patients with unexpected responses

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