HealthDay News — Lenalidomide produces hematologic responses in myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN) with ring sideroblasts (RS) and thrombocytosis (MDS/MPN-RS-T), although these responses are often suboptimal, according to a research letter published online October 25 in the American Journal of Hematology.

Maura Nicolosi, MD, from the Mayo Clinic in Rochester, Minnesota, and colleagues described the treatment of 3 patients with MDS/MPN-RS-T with lenalidomide. 

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The first patient (49-year-old male) obtained his best response (partial platelet response) after 8 cycles and maintained this response for 8 months. He developed recurrent thrombocytosis and progressive anemia after 15 cycles, and lenalidomide was discontinued. The second patient (73-year-old male) had a complete hematological response after 2 cycles of lenalidomide and became red-cell-transfusion-independent. He did not have morphological improvement on follow-up bone marrow examinations. After 19 cycles, he lost his erythroid response and had to come off therapy. The third patient (85-year-old female) had partial platelet response after 2 cycles of lenalidomide; she remained transfusion-dependent and stopped therapy after 2 cycles because of worsening congestive cardiac failure.

“While lenalidomide therapy does produce hematological responses in patients with MDS/MPN-RS-T, these are often suboptimal, without significant changes in bone marrow morphology and are often not durable. Newer, effective therapies are much needed for these patients,” the authors write.

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