Cargando…

Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response

Low-dose thalidomide and prednisone alone or combined are effective therapies in some persons with primary myelofibrosis (PMF) and anemia with or with RBC transfusion dependence. Danazol is also effective in some persons with PMF and anemia. Responses to these drugs are typically incomplete and not...

Descripción completa

Detalles Bibliográficos
Autores principales: Luo, Xueping, Xu, Zefeng, Li, Bing, Qin, Tiejun, Zhang, Peihong, Zhang, Hongli, Fang, Liwei, Pan, Lijuan, Hu, Naibo, Qu, Shiqiang, Zhang, Yue, Huang, Gang, Peter Gale, Robert, Xiao, Zhijian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802625/
https://www.ncbi.nlm.nih.gov/pubmed/29335406
http://dx.doi.org/10.1038/s41408-017-0029-4
_version_ 1783298556942090240
author Luo, Xueping
Xu, Zefeng
Li, Bing
Qin, Tiejun
Zhang, Peihong
Zhang, Hongli
Fang, Liwei
Pan, Lijuan
Hu, Naibo
Qu, Shiqiang
Zhang, Yue
Huang, Gang
Peter Gale, Robert
Xiao, Zhijian
author_facet Luo, Xueping
Xu, Zefeng
Li, Bing
Qin, Tiejun
Zhang, Peihong
Zhang, Hongli
Fang, Liwei
Pan, Lijuan
Hu, Naibo
Qu, Shiqiang
Zhang, Yue
Huang, Gang
Peter Gale, Robert
Xiao, Zhijian
author_sort Luo, Xueping
collection PubMed
description Low-dose thalidomide and prednisone alone or combined are effective therapies in some persons with primary myelofibrosis (PMF) and anemia with or with RBC transfusion dependence. Danazol is also effective in some persons with PMF and anemia. Responses to these drugs are typically incomplete and not sustained. It is unclear whether adding danazol to thalidomide and prednisone would improve efficacy. We retrospectively compared the outcomes of 88 subjects with PMF and anemia receiving thalidomide and prednisone without (n = 46) or with danazol (n = 42). The primary end point was anemia response, which was 71% (95% confidence interval (CI), 57, 85%) in subjects receiving thalidomide/prednisone/danazol compared with 46% (32, 60%; P = 0.014) in those receiving thalidomide/prednisone. Response rates in subjects who were RBC transfusion dependent was also higher in the danazol cohort (61% (38, 84%)) vs. 25% (6, 44%); P = 0.024). Time to response was rapid (median, 2 months (range, 1–11 months)) and similar between the cohorts. Response duration was longer in the thalidomide/prednisone/danazol cohort (HR 2.18 (1.18–5.42); P = 0.019). Adverse effects were mild and similar between the cohorts. In conclusion, thalidomide/prednisone/danazol seems superior to thalidomide/prednisone in persons with PMF and anemia. Our conclusion requires confirmation in a randomized trial.
format Online
Article
Text
id pubmed-5802625
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-58026252018-02-08 Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response Luo, Xueping Xu, Zefeng Li, Bing Qin, Tiejun Zhang, Peihong Zhang, Hongli Fang, Liwei Pan, Lijuan Hu, Naibo Qu, Shiqiang Zhang, Yue Huang, Gang Peter Gale, Robert Xiao, Zhijian Blood Cancer J Article Low-dose thalidomide and prednisone alone or combined are effective therapies in some persons with primary myelofibrosis (PMF) and anemia with or with RBC transfusion dependence. Danazol is also effective in some persons with PMF and anemia. Responses to these drugs are typically incomplete and not sustained. It is unclear whether adding danazol to thalidomide and prednisone would improve efficacy. We retrospectively compared the outcomes of 88 subjects with PMF and anemia receiving thalidomide and prednisone without (n = 46) or with danazol (n = 42). The primary end point was anemia response, which was 71% (95% confidence interval (CI), 57, 85%) in subjects receiving thalidomide/prednisone/danazol compared with 46% (32, 60%; P = 0.014) in those receiving thalidomide/prednisone. Response rates in subjects who were RBC transfusion dependent was also higher in the danazol cohort (61% (38, 84%)) vs. 25% (6, 44%); P = 0.024). Time to response was rapid (median, 2 months (range, 1–11 months)) and similar between the cohorts. Response duration was longer in the thalidomide/prednisone/danazol cohort (HR 2.18 (1.18–5.42); P = 0.019). Adverse effects were mild and similar between the cohorts. In conclusion, thalidomide/prednisone/danazol seems superior to thalidomide/prednisone in persons with PMF and anemia. Our conclusion requires confirmation in a randomized trial. Nature Publishing Group UK 2018-01-15 /pmc/articles/PMC5802625/ /pubmed/29335406 http://dx.doi.org/10.1038/s41408-017-0029-4 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Luo, Xueping
Xu, Zefeng
Li, Bing
Qin, Tiejun
Zhang, Peihong
Zhang, Hongli
Fang, Liwei
Pan, Lijuan
Hu, Naibo
Qu, Shiqiang
Zhang, Yue
Huang, Gang
Peter Gale, Robert
Xiao, Zhijian
Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
title Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
title_full Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
title_fullStr Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
title_full_unstemmed Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
title_short Thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
title_sort thalidomide plus prednisone with or without danazol therapy in myelofibrosis: a retrospective analysis of incidence and durability of anemia response
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802625/
https://www.ncbi.nlm.nih.gov/pubmed/29335406
http://dx.doi.org/10.1038/s41408-017-0029-4
work_keys_str_mv AT luoxueping thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT xuzefeng thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT libing thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT qintiejun thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT zhangpeihong thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT zhanghongli thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT fangliwei thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT panlijuan thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT hunaibo thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT qushiqiang thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT zhangyue thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT huanggang thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT petergalerobert thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse
AT xiaozhijian thalidomideplusprednisonewithorwithoutdanazoltherapyinmyelofibrosisaretrospectiveanalysisofincidenceanddurabilityofanemiaresponse