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CASE REPORT
Refractory primary immune thrombocytopenia with subsequent del(5q) MDS: complete remission of both after lenalidomide
  1. Thomas Bech Mortensen1,
  2. Henrik Frederiksen1,
  3. Claus Werenberg Marcher1,
  4. Birgitte Preiss2
  1. 1Department of Hematology, Odense Universitetshospital, Odense, Denmark
  2. 2Department of Pathology, Odense University Hospital, Odense, Denmark
  1. Correspondence to Dr Thomas Bech Mortensen, tmdemo{at}gmail.com

Summary

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.

https://doi.org/10.1136/bcr-2016-215888

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    Footnotes

    • Contributors TBM is responsible for formulation of the first draft of the article, reviewing the patient medical files and reviewing existing knowledge on the subject. HF is responsible for revising the article critically for important intellectual content and correction of style and grammar. CWM is responsible for treatment and communication with the patient, and revising the article critically for important intellectual content. BP is responsible for revising the article critically for important intellectual content.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.