Lenalidomide Efficacy in Patients with MDS and Del-5q: Real-World Data from the Hellenic (Greek) National Myelodysplastic & Hypoplastic Syndromes Registry (EAKMYS)

<b>Background-Objectives:</b> Although considered standard of care for patients with low-/intermediate-1 risk MDS and isolated del(5q), lenalidomide is not widely used in patients exhibiting additional cytogenetic abnormalities, on top of del(5)q. The aim of this study was to provide real-world evidence for the efficacy of lenalidomide in patients with del(5q), with or without additional cytogenetic abnormalities. <b>Methods:</b> Patients with MDS exhibiting del(5q) in the Greek National Myelodysplastic Syndromes Registry were analyzed if they had received at least one lenalidomide dose and detailed response assessment/follow-up was available. <b>Results:</b> Among 238 patients analyzed, 153 (64.3%) had del(5q) syndrome (Group-I), 34 (14.3%) had an isolated del(5q) abnormality but were not 5q- syndrome (Group-II), 26 (10.9%) had del(5q) plus only one additional cytogenetic abnormality (Group-III), and 25 (10.5%) had del(5q) plus >1 additional abnormality (Group-IV). Among 218 (91.6%) evaluable patients, a major response was achieved by 146 (67.0%) patients, 114/146 (78.1%) in Group-I, 18/31 (58.1%) in Group-II, 10/20 (50.0%) in Group-III, and 4/21 (19.0%) in Group-IV. Overall, hematological response was seen in 177/218 (81.2%) patients, even among those with an excess of bone marrow blasts/frank acute myeloid leukemia. Duration of response was comparable between the four patient groups. A complete cytogenetic response was achieved by 38.0% overall, more commonly in Group-I (42.3%) and -III (35.7%). Transfusion-independent patients and those with a higher MCV or lower marrow blast cells at baseline had a higher probability of achieving a major response. With multivariate analysis, factors associated with overall survival were age, performance status, transfusion dependence, and marrow blast cell percentage at treatment start, as well as time from initial diagnosis to lenalidomide start. <b>Conclusions:</b> Lenalidomide was highly effective in patients with the del(5)q syndrome and also in those with isolated del(5)q, other than del(5)q syndrome, or those exhibiting del(5)q plus only one additional cytogenetic abnormality, not affecting chromosome 7.

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Journal
Cancers
Published
2025-04-22
DOI
https://doi.org/10.3390/cancers17091388
Citations
4
Primary Topic
Acute Myeloid Leukemia Research
Type
article
Field-Weighted Citation Impact
7.08
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article

Lenalidomide Efficacy in Patients with MDS and Del-5q: Real-World Data from the Hellenic (Greek) National Myelodysplastic & Hypoplastic Syndromes Registry (EAKMYS)

Dimitra Liapi, Maria Vagia, Panagiotis Karmas, Evridiki Michali et al.
4 citations
Cancers
Acute Myeloid Leukemia Research
7.08
article

Lenalidomide Efficacy in Patients with MDS and Del-5q: Real-World Data from the Hellenic (Greek) National Myelodysplastic & Hypoplastic Syndromes Registry (EAKMYS)

Dimitra Liapi, Maria Vagia, Panagiotis Karmas, Evridiki Michali, Ιoannis Kotsianidis, Eleni Gavriilaki, Georgia Kaiafa, George Xanthopoulidis, Athanasios Galanopoulos, Argiris Symeonidis, Nora‐Athina Viniou, Menelaos Papoutselis, Eleni Chandrinou, Panayiotis Panayiotidis, Alexandra Kourakli, Maria Dimou, Panagiotis Diamantopoulos, Maria Dalekou‐Tsolakou, Maria Pagoni, Eirini Katodritou, Evangelos Terpos, George Vassilopoulos, Charalampos Pontikoglou, Eleftheria Hatzimichael, Maria Kotsopoulou, Theodora Assimakopoulou, Vassiliki Labropoulou, K. Palla, Anthi Bouchla, Panagiotis Zikos, Theodoros P. Vassilakopoulos, Despoina Mparmparousi, Eleni Sazakli, Vasileios Lazaris, Anna Kioumi, Efthymia Vlachaki, Vassiliki Pappa, Zafiris Kartassis
article en
4 citations

Abstract

<b>Background-Objectives:</b> Although considered standard of care for patients with low-/intermediate-1 risk MDS and isolated del(5q), lenalidomide is not widely used in patients exhibiting additional cytogenetic abnormalities, on top of del(5)q. The aim of this study was to provide real-world evidence for the efficacy of lenalidomide in patients with del(5q), with or without additional cytogenetic abnormalities. <b>Methods:</b> Patients with MDS exhibiting del(5q) in the Greek National Myelodysplastic Syndromes Registry were analyzed if they had received at least one lenalidomide dose and detailed response assessment/follow-up was available. <b>Results:</b> Among 238 patients analyzed, 153 (64.3%) had del(5q) syndrome (Group-I), 34 (14.3%) had an isolated del(5q) abnormality but were not 5q- syndrome (Group-II), 26 (10.9%) had del(5q) plus only one additional cytogenetic abnormality (Group-III), and 25 (10.5%) had del(5q) plus >1 additional abnormality (Group-IV). Among 218 (91.6%) evaluable patients, a major response was achieved by 146 (67.0%) patients, 114/146 (78.1%) in Group-I, 18/31 (58.1%) in Group-II, 10/20 (50.0%) in Group-III, and 4/21 (19.0%) in Group-IV. Overall, hematological response was seen in 177/218 (81.2%) patients, even among those with an excess of bone marrow blasts/frank acute myeloid leukemia. Duration of response was comparable between the four patient groups. A complete cytogenetic response was achieved by 38.0% overall, more commonly in Group-I (42.3%) and -III (35.7%). Transfusion-independent patients and those with a higher MCV or lower marrow blast cells at baseline had a higher probability of achieving a major response. With multivariate analysis, factors associated with overall survival were age, performance status, transfusion dependence, and marrow blast cell percentage at treatment start, as well as time from initial diagnosis to lenalidomide start. <b>Conclusions:</b> Lenalidomide was highly effective in patients with the del(5)q syndrome and also in those with isolated del(5)q, other than del(5)q syndrome, or those exhibiting del(5)q plus only one additional cytogenetic abnormality, not affecting chromosome 7.

CancersVol. 17(9)
University of Crete (GR), University of Thessaly (GR), Democritus University of Thrace (GR), University of Patras (GR), University of Ioannina (GR), National and Kapodistrian University of Athens (GR), Aristotle University of Thessaloniki (GR), Agios Andreas Hospital (GR), Sismanoglio General Hospital (GR), AHEPA University Hospital (GR), Theageneio General Hospital (GR), Papageorgiou General Hospital (GR), General Hospital of Athens G. Genimatas (GR), NIMTS Hospital (GR), Alexandra Hospital (GR), Laiko General Hospital of Athens (GR), The General Hospital of Heraklion "Venizeleio-Pananio" (GR), Chania General Hospital ”St. George” (GR), Metaxa Hospital (GR), Athens Medical Center (GR), University General Hospital Attikon (GR), KAT General Hospital of Attica (GR), G. Papanikolaou General Hospital (GR), Evangelismos Hospital (GR)
Good health and well-being
Openalex Percentile: Top 3%
Acute Myeloid Leukemia Research
7.08
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