Article open access publication

Refractory primary immune thrombocytopenia with subsequent del(5q) MDS: complete remission of both after lenalidomide

BMJ Case Reports, BMJ, ISSN 1757-790X

Volume 2017, 2017

DOI:10.1136/bcr-2016-215888, Dimensions: pub.1008435281, PMC: PMC5256528, PMID: 28052942,



  1. (1) Odense University Hospital, grid.7143.1, Southern Denmark Region






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.

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