, Volume 91, Issue 2, pp 309-310
Date: 28 May 2011

Very short-term lenalidomide treatment associated with durable resolution of anemia in a patient with myelodysplastic syndrome with chromosome 5q deletion

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Dear Editor,

Dose–response relationship and the precise mechanism of action of lenalidomide in myelodysplastic syndromes (MDS) are still unclear, despite the remarkable response rates in patients with chromosome 5q deletion (del 5q) [1, 2]. A selective effect of lenalidomide on the hematopoietic del5q clone has been described, with inhibition of proteins critical for cell survival or stimulation of tumor suppressor genes on that region [3]. In this context, a critical role of the ribosomal protein RPS14, located in the common deleted region of del5q, has been recently reported [4].

During lenalidomide treatment, most patients usually require transient dose interruption followed by dose reduction due to early adverse events (mainly neutropenia and/or thrombocytopenia) [2]. Few case reports have shown sustained long-term RBC-transfusion independency even after short-term treatment [57]. Here, we report a durable response achieved in a patient with del5q MDS after only 17 days of lenalidom