PMID- 27824902
OWN - NLM
STAT- MEDLINE
DCOM- 20170706
LR  - 20181202
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 11
DP  - 2016
TI  - Efficacy and Safety of Lenalidomide for Treatment of Low-/Intermediate-1-Risk 
      Myelodysplastic Syndromes with or without 5q Deletion: A Systematic Review and 
      Meta-Analysis.
PG  - e0165948
LID - 10.1371/journal.pone.0165948 [doi]
LID - e0165948
AB  - BACKGROUND: Lenalidomide could effectively induce red blood cell (RBC) 
      transfusion independence (TI) in patients with lower-risk (Low/Intermediate-1) 
      myelodysplastic syndrome (MDS) with or without 5q deletion. However whether 
      lenalidomide ultimately improves the overall survival (OS) of lower-risk MDS 
      patients and reduces the progression to AML remains controversial. METHOD: A 
      meta-analysis was conducted to examine the efficacy and safety of lenalidomide in 
      the treatment of lower-risk MDS. Efficacy was assessed according to erythroid 
      hematologic response (HI-E), cytogenetic response (CyR), OS and AML progression. 
      Safety was evaluated based on the occurrence rates of grades 3-4 adverse events 
      (AEs). RESULTS: Seventeen studies were included consisting of a total of 2160 
      patients. The analysis indicated that the overall rate of HI-E was 58% with 95% 
      confidence interval (CI) of 43-74%. The pooled estimates for the rates of CyR, 
      complete CyR, and partial CyR were 44% (95% CI 19-68%), 21% (95% CI 13-30%) and 
      23% (95% CI 15-32%), respectively. The patients with 5q deletion had 
      significantly higher rate of HI-E and CyR than those without 5q deletion (P = 
      0.002 and 0.001, respectively). The incidences of grades 3-4 neutropenia, 
      thrombocytopenia, leukopenia, anemia, deep vein thrombosis, diarrhea, fatigue and 
      rash were 51% (95% CI 30-73%), 31% (95% CI 20-42%), 9% (95% CI 5-13%), 7% (95% CI 
      2-12%), 3% (95% CI 2-5%), 3% (95% CI 1-5%), 2% (95% CI 1-4%) and 2% (95% CI 
      1-3%), respectively. Lenalidomide significantly improved OS (HR: 0.62, 95% CI 
      0.47-0.83, P = 0.001) and lowered the risk of AML progression in del(5q) patients 
      (RR: 0.61, 95% CI 0.41-0.91, P = 0.014). CONCLUSIONS: In spite of the AEs, 
      lenalidomide could be effectively and safely used for the treatment of lower-risk 
      MDS patients with or without 5q deletion.
FAU - Lian, Xin-Yue
AU  - Lian XY
AD  - Department of Hematology, Affiliated People's Hospital of Jiangsu University, 
      Zhenjiang, Jiangsu, People's Republic of China.
FAU - Zhang, Zhi-Hui
AU  - Zhang ZH
AD  - Department of Hematology, Affiliated People's Hospital of Jiangsu University, 
      Zhenjiang, Jiangsu, People's Republic of China.
FAU - Deng, Zhao-Qun
AU  - Deng ZQ
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - He, Pin-Fang
AU  - He PF
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - Yao, Dong-Ming
AU  - Yao DM
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - Xu, Zi-Jun
AU  - Xu ZJ
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - Wen, Xiang-Mei
AU  - Wen XM
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - Yang, Lei
AU  - Yang L
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - Lin, Jiang
AU  - Lin J
AD  - Laboratory Center, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 
      Jiangsu, People's Republic of China.
FAU - Qian, Jun
AU  - Qian J
AD  - Department of Hematology, Affiliated People's Hospital of Jiangsu University, 
      Zhenjiang, Jiangsu, People's Republic of China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20161108
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Immunologic Factors)
RN  - 4Z8R6ORS6L (Thalidomide)
RN  - F0P408N6V4 (Lenalidomide)
RN  - Chromosome 5q Deletion Syndrome
SB  - IM
MH  - Anemia, Macrocytic/*drug therapy/genetics
MH  - Chromosome Deletion
MH  - Chromosomes, Human, Pair 5/genetics
MH  - Humans
MH  - Immunologic Factors/adverse effects/*therapeutic use
MH  - Lenalidomide
MH  - Myelodysplastic Syndromes/*drug therapy/genetics
MH  - Thalidomide/adverse effects/*analogs & derivatives/therapeutic use
MH  - Treatment Outcome
PMC - PMC5100926
COIS- The authors have declared that no competing interests exist.
EDAT- 2016/11/09 06:00
MHDA- 2017/07/07 06:00
PMCR- 2016/11/08
CRDT- 2016/11/09 06:00
PHST- 2016/05/17 00:00 [received]
PHST- 2016/10/20 00:00 [accepted]
PHST- 2016/11/09 06:00 [entrez]
PHST- 2016/11/09 06:00 [pubmed]
PHST- 2017/07/07 06:00 [medline]
PHST- 2016/11/08 00:00 [pmc-release]
AID - PONE-D-16-20004 [pii]
AID - 10.1371/journal.pone.0165948 [doi]
PST - epublish
SO  - PLoS One. 2016 Nov 8;11(11):e0165948. doi: 10.1371/journal.pone.0165948. 
      eCollection 2016.