Lenalidomide maintenance after allogeneic HSCT seems to trigger acute graft-versus-host disease in patients with high-risk myelodysplastic syndromes or acute myeloid leukemia and del(5q): results of the LENAMAINT trial

Abstract

Platzbecker U on behalf of the German MDS and Cooperative Transplant Study Group (GCTSG). Lenalidomide maintenance after allogeneic HSCT seems to trigger acute graft-versus-host disease in patients with : results of the LENAMAINT trial. Haematologica 2012;97(9):e34-35. doi:10.3324/haematol.2012 LETTERS TO THE EDITOR© F e r r a t a S t o r t i F o u n d a t i o n © F e r r a t a S t o r t i F o u n d a t i o n

Clinical activity of azacitidine in patients who relapse after allogeneic stem cell transplantation for acute myeloid leukemia

“…Consequently, combined administration of AZA C. Craddock et al 882 haematologica | 2016; 101(7) with lenalidomide, an immunomodulatory drug with the capacity to activate CD8 + T cells, which also has the capacity to salvage patients with relapsed myeloid malignancies who relapse post transplant, would be of interest. 25 In conclusion, our data demonstrate a potentially important role for AZA in the management of selected patients with relapsed AML or MDS after an allograft. Given its acceptable toxicity and ease of administration, these results emphasize a role for AZA as a novel treatment strategy in patients with recurrent disease.…”

Maintenance therapy in acute myeloid leukemia: an evidence-based review of randomized trials

“…Although no maintenance RCT has yet been performed in the post-HCT setting, a number of earlyphase studies have been performed to assess safety and feasibility of maintenance therapy after allo-HCT using HMAs, 68-72 FLT3 inhibitors, [73][74][75][76] histone deacetylase (HDAC) inhibitors, 77 and lenalidomaide. 78 In the largest of these trials, 42 patients with high-risk myelodysplastic syndrome (n 5 5) or AML (n 5 37) in CR after reduced-intensity allo-HCT were treated with the HDAC inhibitor panobinostat using 2 different schedules; 67% of patients received transplantation in active disease. Treatment was started between days 60 and 150 posttransplant and continued for up to 1 year.…”

Lenalidomide combined with mismatched microtransplantation for acute myeloid leukemia

“…HLA-mismatched microtransplantation is a cellular therapy without the requirement for a specific target and a proposed mechanism of action involving both graft-versus-host and host-versus-graft allogeneic responses. 5 The observation that antitumor responses occur in association with rejection of mismatched related donor hematopoietic cells has been reported by our group in the past. In summary, we report on 3 cases of elderly AML who were treated with a microtransplantation protocol incorporating lenalidomide at our institution.…”

“…3 The immunomodulatory agent lenalidomide, at higher doses (eg, 50 mg daily), has been shown to be relatively safe and effective in some patients with advanced AML, 4 and it has also been linked to instigating or enhancing the graft versus malignancy effect following HCT. 5 We hypothesized that lenalidomide may enhance the antileukemia effect in HLA-mismatched donor microtransplantation. Herein, we report the clinical trajectory of 3 patients treated at our site with lenalidomide combined with a mismatched microtransplantation protocol as consolidation therapy.…”