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Erythropoietin is first-line therapy for transfusion-dependent myelodysplastic syndrome (MDS). In patients who fail to respond to this treatment, lenalidomide is occasionally effective (JW Oncol Hematol Jan 22 2008). Because lenalidomide restores the transcriptional response to erythropoietin in MDS progenitors, combining it with erythropoietin might improve hemoglobin levels in patients who are unresponsive to monotherapy with erythropoietin or lenalidomide.
To explore this possibility, investigators conducted an industry-funded, single-center, open-label study of 39 patients who previously failed erythropoietin therapy and were red-blood-cell-transfusion dependent. Two dose levels of lenalidomide were administered: 24 patients received 10 …