Review Article

Annals of Hematology

, Volume 87, Issue 5, pp 345-352

Open Access This content is freely available online to anyone, anywhere at any time.

Practical recommendations on the use of lenalidomide in the management of myelodysplastic syndromes

  • Aristoteles GiagounidisAffiliated withSt. Johannes Hospital, Medizinische Klinik II Email author 
  • , Pierre FenauxAffiliated withService d’Hématologie Clinique, Hôpital Avicenne (AP-HP)
  • , Ghulam J. MuftiAffiliated withDepartment of Haematology, King’s College Hospital
  • , Petra MuusAffiliated withMedical Center, Department of Hematology, Radboud University Nijmegen
  • , Uwe PlatzbeckerAffiliated withMedizinische Klinik und Poliklinik I, University Clinic Carl Gustav Carus
  • , Guillermo SanzAffiliated withHematology Department, Hospital Universitario La Fe
  • , Larry CripeAffiliated withMelvin and Bren Simon Cancer Center, Indiana University
  • , Marie Von Lilienfeld-ToalAffiliated withBMTU, Gledhow Wing, St. James’s University Hospital
  • , Richard A. WellsAffiliated withOdette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto

Abstract

Lenalidomide, an oral immunomodulatory agent, has received approval in the USA from the Food and Drug Administration (FDA) for the management of myelodysplastic syndromes (MDS) classified by the International Prognostic Scoring System (IPSS) as low risk or intermediate-1 risk and with a deletion 5q (del(5q)) cytogenetic abnormality. Although some patients with del(5q) have a relatively good prognosis, all del(5q) patients will become transfusion-dependent at some point during the course of their disease. The results of two clinical trials in more than 160 patients with MDS have demonstrated clear therapeutic benefits of lenalidomide, with >60% of patients achieving independence from transfusion during therapy, irrespective of age, prior therapy, sex, or disease-risk assessment. The recommendations presented in this review will aid the safe administration of lenalidomide for the treatment of patients with low-risk or intermediate-1-risk MDS and a del(5q) cytogenetic abnormality, and they will help physicians avoid unnecessary dose reduction or interruption, thus assuring the best efficacy for patients.

Keywords

Myelodysplastic syndromes MDS Lenalidomide Treatment guidelines