Azacitidine and Lenalidomide for Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) in high-risk patients (those with excess myeloblasts or an International Prognostic Scoring System risk score >1) are characterized by transfusion dependency and evolution to leukemia. Some MDS patients have achieved response from azacitidine (JW Oncol Hematol Nov 23 2010) or lenalidomide (JW Oncol Hematol Jan 22 2008), but whether combining these two agents would be safe and effective has not been established.

To address this possibility, investigators conducted a multicenter, phase II study involving 36 patients with high-risk MDS who received azacitidine (75 mg/m² daily for 5 days) and lenalidomide (10 mg daily for 21 days) in seven 28-day cycles. After two cycles, the median absolute neutrophil count decli…