Abstract
BackgroundParticularly 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.MethodsWe assessed the effect of age on clinical characteristics and outcomes in 286 lenalidomide-treated MDS patients with del(5q) from two multicenter trials.ResultsA 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.ConclusionsBaseline 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 registrationClinicalTrials.gov NCT00065156 and NCT00179621
Highlights
Since the advent of lenalidomide, lower-risk myelodysplastic syndromes (MDS) patients with del(5q) have been the focus of many studies; the impact of age on disease characteristics and response to lenalidomide has not been analyzed
Time to acute myeloid leukemia (AML) progression was assessed after lenalidomide treatment failure
Rates of AML progression were analyzed by time since diagnosis; between-group comparisons and overall comparisons were carried out using the Tukey test and log-rank test, respectively
Summary
Since the advent of lenalidomide, lower-risk myelodysplastic syndromes (MDS) patients with del(5q) have been the focus of many studies; the impact of age on disease characteristics and response to lenalidomide has not been analyzed. Myelodysplastic syndromes (MDS) occur predominantly in patients aged ≥60 years, many of whom have limited treatment options due to comorbidities, functional impairment, or poor medication tolerance [1, 2]. Studies reporting the effect of age on baseline characteristics and treatment outcomes in MDS are limited and usually involve small patient cohorts [3,4,5].
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