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Lenalidomide induces long-lasting responses in elderly patients with chronic lymphocytic leukemia

Paolo Strati, Michael J. Keating, William G. Wierda, Xavier C. Badoux, Steliana Calin, James M. Reuben, Susan O'Brien, Steven M. Kornblau, Hagop M. Kantarjian, Hui Gao, Alessandra Ferrajoli

Key points

  • Treatment with lenalidomide induces long-lasting responses

  • Lenalidomide can produce a sustained increase in immunoglobulin levels and a sustained normalization in circulating T cells

Abstract

We evaluated the long-term outcomes of 60 patients with chronic lymphocytic leukemia (CLL) treated with lenalidomide as initial therapy. At a median follow-up of 4 years, median time to treatment failure has not been reached, overall survival is 82%. Thirty-five (58%) patients had a response lasting more than 36 months (long-term responders, LTRs). Best responses in LTRs consisted of 25 (71%) complete remissions and 10 (29%) partial remissions. Beside clinical responses, an increase in immunoglobulin A, G and M levels of greater than 50% from baseline was reported in 61, 45 and 42% of LTRs. Normalization in the percentage of CD4+ and CD8+ cells and T cell numbers was observed in 48, 71 and 99% of LTRs. Compared to the other patients in the study, LTRs had lower baseline plasma levels of beta-2-microglobulin and were more likely to have trisomy 12 and less likely to have deletion 17p. (Trial registered at http://clinicaltrials.gov, ID: NCT00535873)

  • Submitted April 5, 2013.
  • Accepted June 8, 2013.