Effectiveness and tolerance of low to very low dose thalidomide in low-risk myelodysplastic syndromes

Tamburini, Jérôme; Elie, Caroline; Park, Sophie; Beyne‐Rauzy, Odile; Gardembas, Martine; Berthou, Christian; Mahé, Béatrice; Sanhès, Laurence; Stamatoullas, Aspasia; Vey, Norbert; Aouba, Achille; Slama, Bohrane; Quesnel, Bruno; Vekhoff, Anne; Jj, Sotto; Vassilief, D.; Al-Nawakil, Chadi; Fenaux, Pierre; Dreyfus, François; Bouscary, Didier

doi:10.1016/j.leukres.2008.06.005

Cited by 16 publications

(11 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The response rate we observed in patients with previous failure or relapse after an ESA alone appears comparable to those obtained in this situation with thalidomide, 25 lenalidomide, 26 azacitidine 27 and antithymocyte globulin alone. 28 In patients resistant to an ESA alone, its combination with G-CSF or GM-CSF also yields 20-40% erythroid responses.…”

Section: Side Effects Of Epoetin-b-atra Combinationsupporting

confidence: 83%

Is there a role for all-trans retinoic acid in combination with recombinant erythropoetin in myelodysplastic syndromes? A report on 59 cases

et al. 2009

View full text Add to dashboard Cite

Erythropoiesis-stimulating agents (ESAs) remain the first-line treatment of anemia in lower risk myelodysplastic syndromes (MDS) without 5q deletion. A preliminary report suggested that adding all-trans retinoic acid (ATRA) to ESAs may improve their erythroid response, particularly in patients with high endogenous erythropoietin (EPO) level, and may improve other cytopenias. We conducted a prospective multicenter study of EPO-b and ATRA in anemic MDS patients with marrow blasts o10% and either previous ESA failure or relapse, endogenous EPO 4500 U/l or other cytopenia(s) (absolute neutrophilic count o1.0 G/l or platelets o50 G/l). A total of 59 patients were evaluable after 12 weeks of treatment. The erythroid response rates according to IWG 2000 and 2006 criteria, respectively, were as follows: overall: 49 and 36%; patients with previous ESA failure (n ¼ 28): 43 and 32%; patients with endogenous EPO 4500 U/l (n ¼ 18): 11 and 19%; patients transfused 42 red blood cells units/month (n ¼ 28) 43 and 39%. Only one neutrophil, but no platelet response, and no major side effect were observed. EPO-b-ATRA combination appears a possible therapeutic option in anemia of MDS having failed an ESA alone, but not in patients with high endogenous EPO level, and does not improve neutropenia and thrombocytopenia.

show abstract

Section: Side Effects Of Epoetin-b-atra Combinationsupporting

confidence: 83%

Is there a role for all-trans retinoic acid in combination with recombinant erythropoetin in myelodysplastic syndromes? A report on 59 cases

et al. 2009

View full text Add to dashboard Cite

show abstract

“…This theory is supported by increasing evidence that there is not a clear dose-response relationship between thalidomide dose and myeloma response using dose ranges of 50-400 mg/d (Palumbo et al, 2008;Ponisch et al, 2008). Recent data suggest this may also be true for myelodysplasia (Tamburini et al, 2009).…”

Section: Ultra Low Dose Thalidomide In Myeloma Revisitedmentioning

confidence: 89%

Ultra low dose thalidomide in myeloma revisited

Patrick

Bowcock

2010

Br J Haematol

View full text Add to dashboard Cite

Comparative genome profiling across subtypes of low-grade B-cell lymphoma identifies type-specific and common aberrations that target genes with a role in B-cell neoplasia. Haematologica, 93, 670-679. Hans, C.P., Weisenburger, D.D., Greiner, T.C., Gascoyne, R.D., Delabie, J., Ott, G., Muller-Hermelink, H.K., Campo, E., Braziel, R.M., Jaffe, E.S., Pan, Z., Farinha, P., Smith, L. ., Taborelli, M., Largo, C., Uccella, S., Martini, V., Poretti, G., Gaidano, G., Calabrese, G., Martinelli, G., Baldini, L., Pruneri, G., Capella, C., Zucca, E., Cotter, F.E., Cigudosa, J.C., Ultra low dose thalidomide in myeloma revisitedThalidomide is an effective drug in myeloma but its exact mode of action is unclear. It appears to be immunomodulatory as well as anti-angiogenic. Both these activities may contribute to the anti-myeloma effect of the drug, but the immunomodulatory action is thought probably to be the major contributor (Sze et al, 2006).While traditional cytotoxic drugs show a dose-response relationship within the therapeutic range, a similar correlation between dose and response cannot necessarily be presumed to occur with immunomodulatory drugs. Also, pharmacokinetic data on thalidomide use in humans are not well characterised and show considerable individual variation. The optimal dose Correspondence 232 ª

show abstract

“…Briefly, this cohort included: (i) 48 patients diagnosed between 1998 and May 2006, and part of a series of 403 low or int-1 risk MDS treated with an erythropoiesis-stimulating agent (with or without granulocyte colony-stimulating factor) in three prospective GFM clinical trials or according to guidelines of the GFM and the French Society of Hematology for the use of erythropoiesis-stimulating agents in MDS with anemia (hemoglobin <10 g/dL, with or without transfusion requirement); 8 (ii) 24 patients included during the same period in two consecutive prospective clinical trials of the GFM using thalidomide (in which 120 patients were included overall); 9,10 and (iii) 27 other lower risk MDS patients with 5q deletion who never received lenalidomide and were included at diagnosis between 2003 and 2006 in the prospective French registry of MDS. The results of treatment of part of that comparative cohort have already been reported.…”

Section: Control Cohortmentioning

confidence: 99%

“…The results of treatment of part of that comparative cohort have already been reported. 6,9,10 Sixty-five percent of those patients were dependent on red blood cell transfusions at inclusion into the study. The median follow up from diagnosis was 6.5 years.…”

Section: Control Cohortmentioning

confidence: 99%

Treatment with lenalidomide does not appear to increase the risk of progression in lower risk myelodysplastic syndromes with 5q deletion. A comparative analysis by the Groupe Francophone des Myelodysplasies

Adès¹,

Bras²,

Sébert³

et al. 2011

Haematologica

Self Cite

View full text Add to dashboard Cite

BackgroundAlthough lenalidomide is very effective in the treatment of anemia of lower risk myelodysplastic syndromes with 5q deletion (del 5q), concerns have been raised over the fact that this drug could trigger progression to acute myeloid leukemia in some patients. Design and MethodsNinety-five transfusion-dependent patients with lower risk myelodysplastic syndromes with del 5q were treated with lenalidomide (10 mg/day, for 3 weeks every 4 weeks); six (6.3%) of the patients progressed to acute myeloid leukemia. This cohort of 95 lenalidomide-treated patients was compared to a historical control cohort of 99 patients with lower risk myelodysplastic syndromes with del 5q who never received lenalidomide, using a propensity score approach that can control for potential confounders in non-randomized comparisons. ResultsThe 4-year estimated cumulative incidence of leukemia was 9% in patients treated with lenalidomide and 15.8% in controls who did not receive lenalidomide (P=0.16). ConclusionsUsing a propensity score approach, we found no significant difference in acute myeloid leukemia progression and survival from diagnosis between the cohort treated with lenalidomide and the control cohort.Key words: lenalidomide, myelodysplastic syndrome, 5q deletion, acute myeloid leukemia, progression. Citation: Adès L, Le Bras F, Sebert M, Kelaidi C, Lamy T, Dreyfus F, Eclache V, Delaunay J, Bouscary D, Visanica S, Turlure P, Guerci Bresler A, Cabrol M-P, Banos

show abstract

Effectiveness and tolerance of low to very low dose thalidomide in low-risk myelodysplastic syndromes

Cited by 16 publications

References 11 publications

Is there a role for all-trans retinoic acid in combination with recombinant erythropoetin in myelodysplastic syndromes? A report on 59 cases

Is there a role for all-trans retinoic acid in combination with recombinant erythropoetin in myelodysplastic syndromes? A report on 59 cases

Ultra low dose thalidomide in myeloma revisited

Treatment with lenalidomide does not appear to increase the risk of progression in lower risk myelodysplastic syndromes with 5q deletion. A comparative analysis by the Groupe Francophone des Myelodysplasies

Contact Info

Product

Resources

About