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
Hauptverfasser: 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
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container_issue 6
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container_title Annals of hematology
container_volume 96
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
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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. 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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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