title: Refractory primary immune thrombocytopenia with subsequent del(5q) MDS: complete remission of both after lenalidomide.
abstract: A patient with refractory primary immune thrombocytopenia (ITP) characterised by severe skin and mucosal bleedings was treated with several ITP-directed therapies including cyclophosphamide. He later developed therapy-related del(5q) myelodysplastic syndrome with no dysplastic morphological features in bone marrow. He remained severely thrombocytopenic, which suggests ongoing immune mediated platelet destruction. After two 3 week cycles of low-dose lenalidomide, complete cytogenetic remission and complete normalisation of platelet count were observed. This suggests that lenalidomide may be a viable treatment option for ITP in the presence of del(5q) not responding to standard treatments.
authors.affiliation: Department of Hematology, Odense Universitetshospital, Odense, Denmark.
authors.forename: Thomas Bech
authors.initials: TB
authors.lastname: Mortensen
authors.affiliation: Department of Hematology, Odense Universitetshospital, Odense, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Frederiksen
authors.affiliation: Department of Hematology, Odense Universitetshospital, Odense, Denmark.
authors.forename: Claus Werenberg
authors.initials: CW
authors.lastname: Marcher
authors.affiliation: Department of Pathology, Odense University Hospital, Odense, Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Preiss
mesh_terms: D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics; D004351:Drug Resistance; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced / Q000235:genetics; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D012074:Remission Induction; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide