Peripheral blood cytogenetics allows treatment monitoring and early identification of treatment failure to lenalidomide in MDS patients: results of the LE-MON-5 trial

Transfusion-dependent patients with low- or intermediate-1-risk myelodysplastic syndrome, <5% bone marrow (BM) blasts and isolated 5q-deletion received lenalidomide within the German MDS study group phase-II clinical trial LE-MON-5 (EudraCT:2008-001866-10) of the University of Duesseldorf, German...

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Hauptverfasser: Braulke, Friederike (VerfasserIn) , Nolte, Florian (VerfasserIn) , Hofmann, Wolf-Karsten (VerfasserIn) , Schlenk, Richard Friedrich (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2017
In: Annals of hematology
Year: 2017, Jahrgang: 96, Heft: 6, Pages: 887-894
ISSN:1432-0584
DOI:10.1007/s00277-017-2983-0
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1007/s00277-017-2983-0
Verlag, Volltext: https://link.springer.com/article/10.1007/s00277-017-2983-0
Volltext
Verfasserangaben:Friederike Braulke, Xenia Schulz, Ulrich Germing, Esther Schuler, Uwe Platzbecker, Florian Nolte, Wolf-Karsten Hofmann, Aristoteles Giagounidis, Katharina Götze, Michael Lübbert, Richard F. Schlenk, Julie Schanz, Ulrike Bacher, Arnold Ganser, Guntram Büsche, Anne Letsch, Philippe Schafhausen, Gesine Bug, Tim H. Brümmendorf, Rainer Haas, Lorenz Trümper, Katayoon Shirneshan, Detlef Haase

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520 |a Transfusion-dependent patients with low- or intermediate-1-risk myelodysplastic syndrome, <5% bone marrow (BM) blasts and isolated 5q-deletion received lenalidomide within the German MDS study group phase-II clinical trial LE-MON-5 (EudraCT:2008-001866-10) of the University of Duesseldorf, Germany. Cytogenetic monitoring was performed by chromosome banding analyses (CBA) of BM cells and fluorescence in situ hybridization (FISH) analyses of peripheral blood (PB) mononuclear CD34+ cells using extended probe panels. Out of 144 patients screened for study enrollment, 24% failed to meet inclusion criteria due to cytogenetic findings. Eighty-seven patients were followed with a median observation time of 30 months. Cytogenetic response detected by FISH and CBA in 74 and 66% of patients, respectively, was predictive for hematologic response as well as of high prognostic relevance. After 2 years, AML rate was 8% for all patients. Karyotype evolution was detected in 21 (FISH)-34% (CBA) of patients associated with significantly shorter AML-free survival. Disease progression was first detectable on the cytogenetic level on average 5-6 months before recurrence of transfusion dependence. Our data show for the first time in a prospective setting that a cytogenetic monitoring from the PB helps to early identify treatment failure and progressive disease in lenalidomide-treated patients to improve clinical management. Trial registration: EudraCT:2008-001866-10 
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