Peripheral blood cytogenetics allows treatment monitoring and early identification of treatment failure to lenalidomide in MDS patients: results of the ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-04-03

AUTHORS

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

ABSTRACT

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 More... »

PAGES

887-894

Journal

TITLE

Annals of Hematology

ISSUE

6

VOLUME

96

Author Affiliations

  • Department of Hematology and Medical Oncology, University Medicine of Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany
  • Department of Medical Statistics, University Medicine of Goettingen, Goettingen, Germany
  • Department of Hematology and Oncology, University of Duesseldorf, Duesseldorf, Germany
  • Department of Hematology and Oncology, University of Dresden, Dresden, Germany
  • Department of Hematology and Oncology, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
  • Department of Hematology and Oncology, Marienhospital, Duesseldorf, Germany
  • Department of Hematology and Oncology, Technical University of Munich, Munich, Germany
  • Department of Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
  • Department of Hematology and Oncology, University of Ulm, Germany, now National Center of Tumor Diseases, Heidelberg, Germany
  • Department of Hematology, Hemostaseology and Stem Cell Transplantation, Hannover Medical School (MHH), Hannover, Germany
  • Institute of Pathology, Hannover Medical School (MHH), Hannover, Germany
  • Departement of Hematology and Oncology, Charite University Medical Center Berlin, Berlin, Germany
  • Department of Oncology, Hematology, BMT with section Pneumology, Hubertus Wald Cancer Center, Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • Department of Internal Medicine II, Hematology and Oncology, Johann Wolfgang Goethe University of Frankfurt, Frankfurt, Germany
  • Department of Hematology and Oncology, Hemostaseology and SCT, University Hospital RWTH Aachen, Aachen, Germany
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00277-017-2983-0

    DOI

    http://dx.doi.org/10.1007/s00277-017-2983-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1084510836

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28374162


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