Hong Junshik, Lee Yoo Jin, Bae Sung Hwa, Yi Jun Ho, Park Sungwoo, Chang Myung Hee, Park Young Hoon, Hyun Shin Young, Chung Joo-Seop, Jang Ji Eun, Jung Joo Young, Jeon So-Yeon, Song Seo-Young, Kim Hawk, Kim Dae Sik, Kim Sung-Hyun, Kim Min Kyoung, Han Sang Hoon, Park Seonyang, Kim Yoo-Jin, Lee Je-Hwan
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Blood Res. 2021 Jun 30;56(2):102-108. doi: 10.5045/br.2021.2021086.
To estimate real-world outcomes in East Asian populations, we conducted a nationwide retrospective analysis of the efficacy and safety of lenalidomide for del(5q) myelodysplastic syndrome (MDS) patients with transfusion-dependent anemia in Korea.
Patients aged ≥19 years who had received lenalidomide for the treatment of lower-risk, red blood cell (RBC) transfusion-dependent del(5q) MDS were selected. A filled case report form (CRF) with information from electronic medical records was requested from members of the acute myeloid leukemia (AML)/MDS Working Party of the Korean Society of Hematology. All the CRFs were gathered and analyzed.
A total of 31 patients were included in this study. Of 28 evaluable patients, 19 (67.9%) achieved RBC transfusion independence (RBC-TI). Female sex and the development of thrombocytopenia during treatment were associated with achieving RBC-TI. The most common non-hematologic toxicities were pruritus, fatigue, and rashes. All non-hematologic toxicities of grades ≥3 were limited to rash (12.9%) and pruritus (6.5%). Dose reduction was required in 15 of the 19 responders (78.9%). The most common final stable dosing schedule for the responders was 5 mg once every other day (31.6%).
Lenalidomide efficacy and tolerability were similar in the Asian del(5q) MDS patients and western patients. Dose reduction during treatment was common, but it was not associated with inferior outcomes.
为评估东亚人群的实际治疗效果，我们在韩国开展了一项全国性回顾性分析，以研究来那度胺治疗依赖输血的del(5q)骨髓增生异常综合征（MDS）患者的疗效和安全性。
选取年龄≥19岁、接受来那度胺治疗低危、依赖红细胞（RBC）输血的del(5q) MDS患者。向韩国血液学会急性髓系白血病（AML）/MDS工作组成员索要填写完整的病例报告表（CRF），该表包含电子病历信息。收集并分析所有CRF。
本研究共纳入31例患者。在28例可评估患者中，19例（67.9%）实现了红细胞输血独立（RBC-TI）。女性以及治疗期间血小板减少的发生与实现RBC-TI相关。最常见的非血液学毒性为瘙痒、疲劳和皮疹。所有≥3级非血液学毒性仅限于皮疹（12.9%）和瘙痒（6.5%）。19例缓解者中有15例（78.9%）需要减量。缓解者最常见的最终稳定给药方案为每隔一天5 mg（31.6%）。
来那度胺在亚洲del(5q) MDS患者和西方患者中的疗效和耐受性相似。治疗期间减量很常见，但这与较差的治疗结果无关。
