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Lenalidomide Plus Hypomethylating Agent as a Treatment Option in Acute Myeloid Leukemia With Recurrent Genetic Abnormalities-AML With inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM.

Publication ,  Journal Article
Merz, LE; Perissinotti, AJ; Marini, BL; Burke, PW; Crouch, A; Erba, HP; Bixby, D
Published in: Clin Lymphoma Myeloma Leuk
January 2020

INTRODUCTION: Acute myeloid leukemia (AML) is a heterogeneous clonal hematopoietic neoplasm. The cytogenetic changes associated with AML affect the response rate and survival and are one of the most important independent prognostic factors. AML with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM accounts for 1% to 2% of all forms of AML and has been associated with a younger age at diagnosis, a poor response to standard induction chemotherapy, and very poor long-term prognosis. PATIENTS AND METHODS: We performed a single-center, retrospective cohort study comparing the outcomes with hypomethylating agent (HMA) plus lenalidomide to those with standard intensive induction therapies for newly diagnosed and relapsed/refractory AML with inv(3). RESULTS: Of the 15 patients, 4 (26.7%) had received lenalidomide and HMA as primary therapy. The overall response rate (ORR) was 100% for the 4 patients who had received lenalidomide with HMA as first-line induction therapy. The ORR was 27.3% (3 of 11) for the patients who had received other induction regimens (P = .0256). The duration of response for first induction therapy was an average of 7.4 months after lenalidomide plus an HMA and a mean of 1.5 months after induction with other chemotherapy regimen (P = .057). The ORR for induction and reinduction therapy was also assessed, with an ORR of 21.4% (6 of 28) for alternative chemotherapy regimens and an ORR of 75% (6 of 8) for induction and reinduction with lenalidomide plus HMA (P = .0046). CONCLUSIONS: The high ORR and reasonable duration of response could allow for potentially curative allogeneic hematopoietic cell transplantation for these patients with high-risk AML. Our initial data suggest that lenalidomide plus HMA is a promising approach for patients with AML with inv(3).

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Published In

Clin Lymphoma Myeloma Leuk

DOI

EISSN

2152-2669

Publication Date

January 2020

Volume

20

Issue

1

Start / End Page

24 / 30

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prognosis
  • Mutation
  • Middle Aged
  • Male
  • Leukemia, Myeloid, Acute
  • Lenalidomide
  • Humans
  • Female
  • Cohort Studies
 

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Merz, L. E., Perissinotti, A. J., Marini, B. L., Burke, P. W., Crouch, A., Erba, H. P., & Bixby, D. (2020). Lenalidomide Plus Hypomethylating Agent as a Treatment Option in Acute Myeloid Leukemia With Recurrent Genetic Abnormalities-AML With inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM. Clin Lymphoma Myeloma Leuk, 20(1), 24–30. https://doi.org/10.1016/j.clml.2019.09.615
Merz, Lauren E., Anthony J. Perissinotti, Bernard L. Marini, Patrick W. Burke, Ashley Crouch, Harry P. Erba, and Dale Bixby. “Lenalidomide Plus Hypomethylating Agent as a Treatment Option in Acute Myeloid Leukemia With Recurrent Genetic Abnormalities-AML With inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM.Clin Lymphoma Myeloma Leuk 20, no. 1 (January 2020): 24–30. https://doi.org/10.1016/j.clml.2019.09.615.
Merz, Lauren E., et al. “Lenalidomide Plus Hypomethylating Agent as a Treatment Option in Acute Myeloid Leukemia With Recurrent Genetic Abnormalities-AML With inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM.Clin Lymphoma Myeloma Leuk, vol. 20, no. 1, Jan. 2020, pp. 24–30. Pubmed, doi:10.1016/j.clml.2019.09.615.
Merz LE, Perissinotti AJ, Marini BL, Burke PW, Crouch A, Erba HP, Bixby D. Lenalidomide Plus Hypomethylating Agent as a Treatment Option in Acute Myeloid Leukemia With Recurrent Genetic Abnormalities-AML With inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM. Clin Lymphoma Myeloma Leuk. 2020 Jan;20(1):24–30.
Journal cover image

Published In

Clin Lymphoma Myeloma Leuk

DOI

EISSN

2152-2669

Publication Date

January 2020

Volume

20

Issue

1

Start / End Page

24 / 30

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prognosis
  • Mutation
  • Middle Aged
  • Male
  • Leukemia, Myeloid, Acute
  • Lenalidomide
  • Humans
  • Female
  • Cohort Studies