Relationship between lenalidomide dose modification, duration of therapy, and long-term outcomes in patients with myelodysplastic syndromes

Amy E. DeZern, Gary Binder, Quanhong Ni, Michael McGuire, B. Douglas Smith

Research output: Contribution to journalArticlepeer-review

Abstract

Dose reductions or interruptions may be required to manage treatment-associated adverse events among patients with myelodysplastic syndromes (MDS) treated with lenalidomide; such modifications are recommended to sustain therapy and maximize treatment duration. The aim of this retrospective case-control study was to determine the relationship between lenalidomide dose modification (DM), duration of lenalidomide therapy (DOT), and patient outcomes in patients with MDS. Those patients with database follow-up >20 months (n = 305) were more likely to have received erythropoiesis-stimulating agents (ESAs) (P = 0.004), had longer median DOT (P < 0.001), and higher rate of DM (P < 0.001) versus those with shorter follow-up (n = 306). Multivariate analysis indicated that lenalidomide DM (odds ratio [OR] 1.08) and prior ESA treatment (OR 2.40) were significantly associated with longer follow-up; transfusion dependence before lenalidomide initiation was associated with a significantly shorter follow-up (OR 0.60). These data suggest that effective management of lenalidomide treatment using dose reduction and/or delay is associated with longer DOT, which can improve patient outcomes.

Original languageEnglish (US)
Pages (from-to)10-14
Number of pages5
JournalLeukemia Research
Volume63
DOIs
StatePublished - Dec 2017

Keywords

  • Dose modification
  • Lenalidomide
  • Myelodysplastic syndromes
  • Outcomes research

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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