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Treatment of deletion 5q acute myeloid leukemia with lenalidomide

Leukemia volume 21, pages 586–588 (2007)Cite this article

Lenalidomide (Revlimid) is an immunomodulatory drug that yields a high frequency of erythroid, pathologic, and cytogenetic response in patients with myelodysplastic syndromes (MDS) with an interstitial deletion of the long arm of chromosome 5 (del 5q). We report here the case of a patient with acute myeloid leukemia (AML) (acute panmyelosis with myelofibrosis) with chromosome 5q deletion who achieved a complete hematologic and cytogenetic remission with lenalidomide treatment.

On 10 May 2006, the patient began treatment with lenalidomide 10 mg/day. Baseline WBC count was 2.81 k/ul, Hb 7.2 g/dl, platelet count 49 k/ul. The lenalidomide was discontinued after 14 days due to worsening neutropenia (absolute neutrophil count (ANC) 0.04 k/ul) and thrombocytopenia (platelet count 12 k/ul). Supportive care with platelet transfusions and granulocyte colony stimulating factor (G-CSF) was initiated. On 15 June 2006, the platelet count was 29 k/ul, ANC was 0.7 k/ul, and lenalidomide was resumed at 5 mg/day. By 14 July 2006, the platelet count was 54 k/ul, ANC 1.5 k/ul, and Hb 9.2 g/dl. A bone marrow biopsy (Figure 1c) revealed 30% cellularity, continued marked reticulin fibrosis, and blasts less than 5%. Cytogenetic analysis revealed 46,XX in all 20 metaphases examined. On 26 July 2006, platelets had increased to 130 k/ul, ANC 5.27 k/ul. The RBC transfusion interval had increased from once weekly at the time of lenalidomide initiation to biweekly. On 13 September 2006, blood counts normalized, and the patient has been transfusion independent for over 2 months (Table 1).

Table 1 Peripheral blood analysis
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  1. Department of Interdisciplinary Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, USA

    J E Lancet, A F List & L C Moscinski

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  1. J E Lancet
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Correspondence to J E Lancet.

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Lancet, J., List, A. & Moscinski, L. Treatment of deletion 5q acute myeloid leukemia with lenalidomide. Leukemia 21, 586–588 (2007). https://doi.org/10.1038/sj.leu.2404526

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