来那度胺治疗的 RBC 输血依赖的低危 MDS 和 del(5q)患者的年龄特征和转归。
Clinical characteristics and outcomes according to age in lenalidomide-treated patients with RBC transfusion-dependent lower-risk MDS and del(5q).
机构信息
Service d'Hématologie Séniors, Hôpital Saint-Louis, Université Paris 7, 1 Avenue Claude Vellefaux, 75475, Paris, France.
Marien Hospital Düsseldorf, Düsseldorf, Germany.
出版信息
J Hematol Oncol. 2017 Jun 26;10(1):131. doi: 10.1186/s13045-017-0491-2.
BACKGROUND
Particularly since the advent of lenalidomide, lower-risk myelodysplastic syndromes (MDS) patients with del(5q) have been the focus of many studies; however, the impact of age on disease characteristics and response to lenalidomide has not been analyzed.
METHODS
We assessed the effect of age on clinical characteristics and outcomes in 286 lenalidomide-treated MDS patients with del(5q) from two multicenter trials.
RESULTS
A total of 33.9, 34.3, and 31.8% patients were aged <65 years, ≥65 to <75 years, and ≥75 years, respectively. Age <65 years was associated with less favorable International Prognostic Scoring System (IPSS) risk and additional cytopenias at baseline versus older age groups, significantly lower cytogenetic response rates (p = 0.022 vs. ≥65 to <75 years; p = 0.047 vs. ≥75 years), and higher rates of acute myeloid leukemia (AML) progression (Gray's test, p = 0.013). Lenalidomide was equally well tolerated across age groups, producing consistently high rates of red blood cell transfusion independence ≥26 weeks.
CONCLUSIONS
Baseline disease characteristics and AML progression appear to be more severe in younger lower-risk MDS patients with del(5q), whereas older age does not seem to compromise the response to lenalidomide.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00065156 and NCT00179621.
背景
自来那度胺问世以来，低危骨髓增生异常综合征（MDS）伴 del(5q)患者一直是许多研究的焦点；然而，年龄对疾病特征和来那度胺反应的影响尚未得到分析。
方法
我们评估了年龄对两项多中心试验中 286 例接受来那度胺治疗的 MDS 伴 del(5q)患者临床特征和结局的影响。
结果
分别有 33.9%、34.3%和 31.8%的患者年龄<65 岁、≥65 至<75 岁和≥75 岁。年龄<65 岁与国际预后评分系统（IPSS）风险较低和基线时存在更多的血细胞减少症有关，与年龄较大的组相比，细胞遗传学反应率显著较低（p=0.022 比≥65 至<75 岁；p=0.047 比≥75 岁），急性髓系白血病（AML）进展率更高（格雷氏检验，p=0.013）。各年龄组均能良好耐受来那度胺，始终保持≥26 周红细胞输注独立性的高反应率。
结论
低危 MDS 伴 del(5q)的年轻患者的基线疾病特征和 AML 进展似乎更为严重，而年龄似乎并不影响来那度胺的反应。
试验注册
ClinicalTrials.gov NCT00065156 和 NCT00179621。
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