Clinical effectiveness of DNA methyltransferase inhibitors and lenalidomide in older patients with refractory anemia with ring sideroblasts: a population-based study in the United States. Issue 10 (24th August 2021)

• Record Type: Journal Article
• Authors: Wang, Xiaoyi; Zeidan, Amer M.; Wang, Rong; Bewersdorf, Jan P.; Zhang, Chi; Podoltsev, Nikolai A.; Huntington, Scott F.; Gore, Steven D.; Ma, Xiaomei
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 10(2021)
• Page Start: 2438
• Page End: 2447
• Publication Date: 2021-08-24
• Subjects: DNA methyltransferase inhibitors -- lenalidomide -- nondel(5q) lower-risk myelodysplastic syndromes -- ring sideroblast -- survival -- transfusion; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1913142
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Existing studies regarding the role of DNA methyltransferase inhibitors (DNMTi) and lenalidomide in refractory anemia with ring sideroblasts (RARS) are limited. Using the surveillance, epidemiology, and end results-medicare database, we assembled a population-based cohort of older adults diagnosed with non-del(5q) lower-risk myelodysplastic syndromes during 2007–2015. Of 2167 patients, 30% had RARS. About 16% of RARS and non- ring sideroblasts (RS) patients received DNMTi. RARS patients were more likely to receive lenalidomide (11.1% vs. 7.1%, p < 0.01). Among patients who were transfusion-dependent at treatment initiation, 55.6% of those treated with DNMTi only and 42.5% treated with lenalidomide only achieved red blood cell transfusion independence (RBC-TI) for a median duration of 21 and 12 weeks, respectively. RS status did not impact rate of RBC-TI. RARS patients had a significantly better survival, and the median survival of RARS patients varied by treatment group. In this population-based study of older RARS patients, DNMTi and lenalidomide were clinically active.