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,
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Veröffentlicht in: | Annals of hematology 2017-06, Vol.96 (6), p.887-894 |
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creator | Braulke, Friederike Schulz, Xenia Germing, Ulrich Schuler, Esther Platzbecker, Uwe Nolte, Florian Hofmann, Wolf-Karsten Giagounidis, Aristoteles Götze, Katharina Lübbert, Michael Schlenk, Richard F. Schanz, Julie Bacher, Ulrike Ganser, Arnold Büsche, Guntram Letsch, Anne Schafhausen, Philippe Bug, Gesine Brümmendorf, Tim H. Haas, Rainer Trümper, Lorenz Shirneshan, Katayoon Haase, Detlef |
description | Transfusion-dependent patients with low- or intermediate-1-risk myelodysplastic syndrome, |
doi_str_mv | 10.1007/s00277-017-2983-0 |
format | Article |
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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</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-017-2983-0</identifier><identifier>PMID: 28374162</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors - therapeutic use ; Antigens, CD34 - blood ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 5 - genetics ; Disease-Free Survival ; Female ; Germany ; Hematology ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Leukemia, Myeloid - diagnosis ; Leukemia, Myeloid - genetics ; Leukocytes, Mononuclear - metabolism ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Myelodysplastic Syndromes - drug therapy ; Myelodysplastic Syndromes - genetics ; Oncology ; Original Article ; Prognosis ; Thalidomide - analogs & derivatives ; Thalidomide - therapeutic use ; Treatment Failure</subject><ispartof>Annals of hematology, 2017-06, Vol.96 (6), p.887-894</ispartof><rights>Springer-Verlag Berlin Heidelberg 2017</rights><rights>Annals of Hematology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-5719a19a94a14e636747edea0ae7f87b0fbdc611d87d152e668af5da835046b3</citedby><cites>FETCH-LOGICAL-c372t-5719a19a94a14e636747edea0ae7f87b0fbdc611d87d152e668af5da835046b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-017-2983-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-017-2983-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28374162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Braulke, Friederike</creatorcontrib><creatorcontrib>Schulz, Xenia</creatorcontrib><creatorcontrib>Germing, Ulrich</creatorcontrib><creatorcontrib>Schuler, Esther</creatorcontrib><creatorcontrib>Platzbecker, Uwe</creatorcontrib><creatorcontrib>Nolte, Florian</creatorcontrib><creatorcontrib>Hofmann, Wolf-Karsten</creatorcontrib><creatorcontrib>Giagounidis, Aristoteles</creatorcontrib><creatorcontrib>Götze, Katharina</creatorcontrib><creatorcontrib>Lübbert, Michael</creatorcontrib><creatorcontrib>Schlenk, Richard F.</creatorcontrib><creatorcontrib>Schanz, Julie</creatorcontrib><creatorcontrib>Bacher, Ulrike</creatorcontrib><creatorcontrib>Ganser, Arnold</creatorcontrib><creatorcontrib>Büsche, Guntram</creatorcontrib><creatorcontrib>Letsch, Anne</creatorcontrib><creatorcontrib>Schafhausen, Philippe</creatorcontrib><creatorcontrib>Bug, Gesine</creatorcontrib><creatorcontrib>Brümmendorf, Tim H.</creatorcontrib><creatorcontrib>Haas, Rainer</creatorcontrib><creatorcontrib>Trümper, Lorenz</creatorcontrib><creatorcontrib>Shirneshan, Katayoon</creatorcontrib><creatorcontrib>Haase, Detlef</creatorcontrib><title>Peripheral blood cytogenetics allows treatment monitoring and early identification of treatment failure to lenalidomide in MDS patients: results of the LE-MON-5 trial</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>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</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Antigens, CD34 - blood</subject><subject>Chromosome Banding</subject><subject>Chromosome Deletion</subject><subject>Chromosomes, Human, Pair 5 - genetics</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Germany</subject><subject>Hematology</subject><subject>Humans</subject><subject>In Situ Hybridization, Fluorescence</subject><subject>Karyotyping</subject><subject>Leukemia, Myeloid - diagnosis</subject><subject>Leukemia, Myeloid - genetics</subject><subject>Leukocytes, Mononuclear - metabolism</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myelodysplastic Syndromes - drug therapy</subject><subject>Myelodysplastic Syndromes - genetics</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Prognosis</subject><subject>Thalidomide - analogs & derivatives</subject><subject>Thalidomide - therapeutic use</subject><subject>Treatment Failure</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1rFTEUhoMo9lr9AW4k4MZNNCfzkYw7qVULt61g9yEzOdOmZCZjkkHuH_J3muutUgoNB7I4z_uG8BDyGvh74Fx-SJwLKRkHyUSnKsafkA3UlWC8UfVTsuFd1bGmnCPyIqVbzkGoWjwnR0JVsoZWbMjv7xjdcoPReNr7ECwddjlc44zZDYka78OvRHNEkyecM53C7HKIbr6mZrYUTfQ76mxZudENJrsw0zDeC4zG-TUizYF6nI13NkyFp26m559_0KVECpY-0ohp9Tn9Td8g3Z6y88sL1pQqZ_xL8mw0PuGru_uYXH05vTr5xraXX89OPm3ZUEmRWSOhM2W62kCNbdXKWqJFww3KUcmej70dWgCrpIVGYNsqMzbWqKrhddtXx-TdoXaJ4eeKKevJpQG9NzOGNWlQqgbJgbcFffsAvQ1rLB_cU50AIQCqQsGBGmJIKeKol-gmE3cauN471AeHujjUe4eal8ybu-a1n9D-T_yTVgBxANKyF4Hx3tOPtv4BJRipUQ</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Braulke, Friederike</creator><creator>Schulz, Xenia</creator><creator>Germing, Ulrich</creator><creator>Schuler, Esther</creator><creator>Platzbecker, Uwe</creator><creator>Nolte, Florian</creator><creator>Hofmann, Wolf-Karsten</creator><creator>Giagounidis, Aristoteles</creator><creator>Götze, Katharina</creator><creator>Lübbert, Michael</creator><creator>Schlenk, Richard F.</creator><creator>Schanz, Julie</creator><creator>Bacher, Ulrike</creator><creator>Ganser, Arnold</creator><creator>Büsche, Guntram</creator><creator>Letsch, Anne</creator><creator>Schafhausen, Philippe</creator><creator>Bug, Gesine</creator><creator>Brümmendorf, Tim H.</creator><creator>Haas, Rainer</creator><creator>Trümper, Lorenz</creator><creator>Shirneshan, Katayoon</creator><creator>Haase, Detlef</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Peripheral blood cytogenetics allows treatment monitoring and early identification of treatment failure to lenalidomide in MDS patients: results of the LE-MON-5 trial</title><author>Braulke, Friederike ; Schulz, Xenia ; Germing, Ulrich ; Schuler, Esther ; Platzbecker, Uwe ; Nolte, Florian ; Hofmann, Wolf-Karsten ; Giagounidis, Aristoteles ; Götze, Katharina ; Lübbert, Michael ; Schlenk, Richard F. ; Schanz, Julie ; Bacher, Ulrike ; Ganser, Arnold ; Büsche, Guntram ; Letsch, Anne ; Schafhausen, Philippe ; Bug, Gesine ; Brümmendorf, Tim H. ; Haas, Rainer ; Trümper, Lorenz ; Shirneshan, Katayoon ; Haase, Detlef</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-5719a19a94a14e636747edea0ae7f87b0fbdc611d87d152e668af5da835046b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiogenesis Inhibitors - 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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</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28374162</pmid><doi>10.1007/s00277-017-2983-0</doi><tpages>8</tpages></addata></record> |
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subjects | Acute Disease Adult Aged Aged, 80 and over Angiogenesis Inhibitors - therapeutic use Antigens, CD34 - blood Chromosome Banding Chromosome Deletion Chromosomes, Human, Pair 5 - genetics Disease-Free Survival Female Germany Hematology Humans In Situ Hybridization, Fluorescence Karyotyping Leukemia, Myeloid - diagnosis Leukemia, Myeloid - genetics Leukocytes, Mononuclear - metabolism Male Medicine Medicine & Public Health Middle Aged Myelodysplastic Syndromes - drug therapy Myelodysplastic Syndromes - genetics Oncology Original Article Prognosis Thalidomide - analogs & derivatives Thalidomide - therapeutic use Treatment Failure |
title | Peripheral blood cytogenetics allows treatment monitoring and early identification of treatment failure to lenalidomide in MDS patients: results of the LE-MON-5 trial |
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