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A systematic review and meta-analysis of the efficacy and adverse events of azacitidine-plus-lenalidomide treatment for patients with acute myeloid leukemia, myelodysplastic syndromes and chronic myelomonocytic leukemia
| Content Provider | Scilit |
|---|---|
| Author | Kunacheewa, Chutima Thongthang, Pakaporn Ungprasert, Patompong Utchariyaprasit, Eakkapol Owattanapanich, Weerapat |
| Copyright Year | 2019 |
| Description | The addition of lenalidomide (LEN) to azacitidine (AZA) may further improve the outcomes of acute myeloid leukemia (AML) patients as well as patients with high-risk myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML) patients although the evidence for this combination treatment is still relatively limited. This meta-analysis aimed to evaluate efficacy and adverse effects of AZA plus LEN for the treatment of patients with high-risk MDS, AML or CMML. The current study systematically identified all cohort studies of patients with AML and/or MDS and/or CMML who received AZA in combination with LEN that reported the overall complete remission (CR) rate and/or overall response rate (ORR). A DerSimonian–d random–effects model with double arcsine transformation was used for the pooled rates and 95% confidence interval (CI) of the all outcomes. A total of 10 studies with 406 patients were identified and included into the meta-analysis. The pooled CR rate after the treatment with AZA-plus-LEN regimen was 33.0% (95% CI, 27.7%–38.7%, $I^{2}$ = 18%) while the pooled ORR was 49.9% (95% CI, 38.4%–61.5%, $I^{2}$ = 72%). Nonetheless, adverse events including grade 3–4 neutrophil toxicity events, platelet toxicity events and febrile neutropenia were common with AZA-plus-LEN regimen. The current study may serve as a preliminary data to suggest that the addition of LEN may offer incremental benefit to patients with high-risk MDS, AML and CMML. However, randomized-controlled studies that directly compare the efficacy and adverse events of AZA-plus-LEN regimen versus AZA monotherapy are still needed. |
| Related Links | https://www.tandfonline.com/doi/pdf/10.1080/16078454.2019.1631425?needAccess=true |
| Ending Page | 506 |
| Page Count | 9 |
| Starting Page | 498 |
| ISSN | 10245332 |
| e-ISSN | 16078454 |
| DOI | 10.1080/16078454.2019.1631425 |
| Journal | Hematology |
| Issue Number | 1 |
| Volume Number | 24 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2019-01-01 |
| Access Restriction | Open |
| Subject Keyword | Hematology :azacitidine Lenalidomide Acute Myeloid Leukemia Myelodysplastic Syndrome Chronic Myelomonocytic Leukemia |
| Content Type | Text |
| Resource Type | Review |
| Subject | Hematology |
