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dc.contributor.authorEve, H
dc.contributor.authorCarey, S
dc.contributor.authorRichardson, S
dc.contributor.authorHeise, C
dc.contributor.authorMamidipudi, V
dc.contributor.authorShi, T
dc.contributor.authorRadford, John A
dc.contributor.authorAuer, R
dc.contributor.authorBullard, S
dc.contributor.authorRule, S
dc.date.accessioned2012-12-28T15:53:22Z
dc.date.available2012-12-28T15:53:22Z
dc.date.issued2012-10
dc.identifier.citationSingle-agent lenalidomide in relapsed/refractory mantle cell lymphoma: results from a UK phase II study suggest activity and possible gender differences. 2012, 159 (2):154-63 Br J Haematolen_GB
dc.identifier.issn1365-2141
dc.identifier.pmid22881386
dc.identifier.doi10.1111/bjh.12008
dc.identifier.urihttp://hdl.handle.net/10541/263693
dc.description.abstractWe present data from a phase II study investigating a novel treatment strategy for relapsed/refractory mantle cell lymphoma (MCL). Twenty-six patients received lenalidomide 25 mg/d (days 1-21 of a 28-d cycle) for up to 6 cycles followed by low-dose maintenance lenalidomide (15 mg) in responding patients. Eight patients achieved complete or partial response to give an overall response rate of 31% with median response duration of 22·2 months [95% confidence interval (CI) 0·0-53·6] and median progression-free survival (PFS) of 3·9 months (95% CI 0·0-11·1). An additional six patients (23%) achieved stable disease. Eleven patients received maintenance with median PFS of 14·6 months (95% CI 7·3-21·9). Correlative studies showed that peripheral T and Natural Killer (NK) cells increased in responding patients by 40-60% over the first 6 cycles with an initial dip in NK cells suggestive of tumour infiltration. Peripheral regulatory T cells were increased in MCL patients (P = 0·001) and expanded further following lenalidomide. Sequential plasma analysis showed increased IL12 p40 and IL7 alongside decreased MMP9, IL10, and adiponectin. Finally, a significant correlation (P = 0·02) between gender and response suggested that female MCL patients were more sensitive to lenalidomide than males. In summary, we confirm the activity, safety and immunomodulatory properties of lenalidomide in MCL and highlight its potential as a low-dose maintenance agent.
dc.language.isoenen
dc.rightsArchived with thanks to British journal of haematologyen_GB
dc.subject.meshAdiponectin
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshAntineoplastic Agents
dc.subject.meshDisease-Free Survival
dc.subject.meshFemale
dc.subject.meshGreat Britain
dc.subject.meshHumans
dc.subject.meshInterleukin-10
dc.subject.meshInterleukin-12 Subunit p40
dc.subject.meshLeukocyte Count
dc.subject.meshLymphoma, Mantle-Cell
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshRecurrence
dc.subject.meshSex Characteristics
dc.subject.meshSex Factors
dc.subject.meshSurvival Rate
dc.subject.meshThalidomide
dc.titleSingle-agent lenalidomide in relapsed/refractory mantle cell lymphoma: results from a UK phase II study suggest activity and possible gender differences.en
dc.typeArticleen
dc.contributor.departmentDepartment of Haematology, Derriford Hospital, Plymouth, UK.en_GB
dc.identifier.journalBritish Journal of Haematologyen_GB
html.description.abstractWe present data from a phase II study investigating a novel treatment strategy for relapsed/refractory mantle cell lymphoma (MCL). Twenty-six patients received lenalidomide 25 mg/d (days 1-21 of a 28-d cycle) for up to 6 cycles followed by low-dose maintenance lenalidomide (15 mg) in responding patients. Eight patients achieved complete or partial response to give an overall response rate of 31% with median response duration of 22·2 months [95% confidence interval (CI) 0·0-53·6] and median progression-free survival (PFS) of 3·9 months (95% CI 0·0-11·1). An additional six patients (23%) achieved stable disease. Eleven patients received maintenance with median PFS of 14·6 months (95% CI 7·3-21·9). Correlative studies showed that peripheral T and Natural Killer (NK) cells increased in responding patients by 40-60% over the first 6 cycles with an initial dip in NK cells suggestive of tumour infiltration. Peripheral regulatory T cells were increased in MCL patients (P = 0·001) and expanded further following lenalidomide. Sequential plasma analysis showed increased IL12 p40 and IL7 alongside decreased MMP9, IL10, and adiponectin. Finally, a significant correlation (P = 0·02) between gender and response suggested that female MCL patients were more sensitive to lenalidomide than males. In summary, we confirm the activity, safety and immunomodulatory properties of lenalidomide in MCL and highlight its potential as a low-dose maintenance agent.


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