title: 5q- syndrome and multiple myeloma diagnosed simultaneously and successful treated with lenalidomide.
abstract: A 72-year-old woman was diagnosed with 5q- myelodysplastic syndrome in the course of an indolent multiple myeloma (MM). Bone marrow (BM) cytogenetics disclosed two unrelated clones: 46,XX,del(5)(q13q33), and [47,X,-X,der(1;21)(q10;q10),-4,-4,+5,del(5)(q13q31),+7,der(7)t(1;7)(p34.2;p22),add(8)(p23),-13,+15,der(16) t(1;16)(q23;q12.2),+19,-21,+mar1,+mar2]. The last complex karyotype belonged to malignant plasma cells. FISH and SKY techniques demonstrated different 5q deletions. EGR1 gene (on 5q31) lost in 5q- syndrome remained in 5q- plasma cells. Biclonal evolution was noted: myeloid 5q- cells added a deletion 13q and plasma cells showed monosomy 13. Patient achieved complete cytogenetic response of 5q- syndrome with low-dose of lenalidomide, and a partial remission of MM with high-dose of lenalidomide/dexamethasone combination.
authors.affiliation: Unidad de Citogenética Hematológica, Hospital Universitario Vall d'Hebrón, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Ortega
authors.forename: Mar
authors.initials: M
authors.lastname: Mallo
authors.forename: Francesc
authors.initials: F
authors.lastname: Solé
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez-Morata
authors.forename: Laura
authors.initials: L
authors.lastname: López-Andreoni
authors.forename: Noemí
authors.initials: N
authors.lastname: Martínez-Morgado
authors.forename: Mercedes
authors.initials: M
authors.lastname: Gironella
authors.forename: David
authors.initials: D
authors.lastname: Valcárcel
authors.forename: Teresa
authors.initials: T
authors.lastname: Vallespí
mesh_terms: D059786:Abnormal Karyotype; D000368:Aged; D000748:Anemia, Macrocytic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002871:Chromosome Banding; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D000077269:Lenalidomide
keywords: 5q−; BM; Lenalidomide; Multiple myeloma; SKY; Unrelated clones