Efficacy and safety of lenalidomide for the treatment of acute myeloid leukemia: a systematic review and meta-analysis

Abstract

Chun-Hong Xie, Min Wei, Fei-Yan Yang, Fu-Zhen Wu, Lei Chen, Jian-Kun Wang, Qin Liu, Jin-Xiong Huang Department of Hematology, Affiliated Liuzhou People’s Hospital of Guangxi University of Science and Technology (Liuzhou People’s Hospital), Liuzhou 545000, Guangxi, China Background: Lenalidomide is effective for the treatment of low-risk myelodysplastic syndromes with deletion 5q abnormalities. However, whether lenalidomide leads to a significant improvement in treatment response and overall survival (OS) in cases of acute myeloid leukemia (AML) remains controversial. A systematic review and a meta-analysis were performed to evaluate the efficacy and safety of lenalidomide in the treatment of AML.Methods: Clinical studies were identified from the Cochrane Central Register of Controlled Trials, PubMed, Embase, and ClinicalTrials.gov. Efficacy outcomes included overall response rate (ORR), complete remission (CR), and OS. Safety was evaluated based on the incidence of grade 3 and 4 treatment-related adverse events (AEs).Results: Eleven studies were included in our meta-analysis; collectively these studies featured 407 AML patients. Pooled estimates for overall ORR and CR were 31% (95% CI: 26%–36%) and 21% (95% CI: 16%–27%), respectively. Thrombocytopenia, anemia, neutropenia, and infection were the most common grade 3 and 4 AEs.Conclusion: Lenalidomide may have some clinical activity in AML, but the population that would benefit from lenalidomide and incorporating lenalidomide into combination drug strategies need to be better defined. Keywords: azacitidine, cytarabine, immunomodulatory agent, cytogenetic risk

Keywords

• azacitidine
• overall response rate
• complete remission
• adverse events.