Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 629

Lenalidomide, a thalidomide analogue, is approved by the FDA and EMA for the treatment of transfusion‐dependent, low‐ and intermediate‐1‐risk MDS with a del(5q). These patients usually have high endogenous EPO levels and higher clonality rate in progenitors cells that predict a worse response to ESA. Treatment with lenalidomide achieves transfusion independence in up to 70% of patients, with long‐lasting responses (median response duration: two years). In RCTs, a high rate of progression to AML has been reported (40% of patients).⁸⁸

A phase 3 placebo‐controlled study investigated lenalidomide in non‐del(5q) patients with RBC‐TD refractory to ESA. Almost 27% of patients treated with lenalidomide achieved RBC transfusion independence for more than eight weeks.⁸⁹ However, the manufacturer decided not to apply for regulatory approval of lenalidomide for this indication.