Abstract 4286

AML M-4 with >30% bone marrow myeloblasts was detected in 63 y old woman 2 mo after a diagnosis of chronic myelomonocytic leukemia (CMMLgrade 2). Cytogenetics showed 46, XX, del(5)(q12 q14) (N=4)/46, XX (N=18). Immune-phenotyping showed CD34+ CD117+ CD13+ CD33+ CD38+ HLADR+ CD2+. Leukemia cells were negative for inv (16), BCR/ABL, NPM, TEL/AML1, MLL/AF4, PML/RARA and AML1/ETO. She was RBC-transfusion-dependent. Therapy with cytarabine and daunorubicin and later with FLAG was ineffective and bone marrow myeloblasts increased to >70% with severe granulocytopenia and infection including pulmonary aspergillosis. She then received lenalidomide, 10 mg/d for 21 d every 4 w Bone marrow myeloblasts decreased to about 20% and granulocytopenia resolved. RBC-transfusion–dependence decreased. Cytogenetic and FISH-testing showed no detectable cells with del(5). This has persisted for 5 mo.

Disclosures:

Off Label Use: Lenalidomide for the treatment of AML with 5q- deletion.

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Topics:
lenalidomide, agranulocytosis, bcr-abl tyrosine kinase, bronchopulmonary aspergillosis, cytarabine, daunorubicin, infections, leukemia, leukemia, myelomonocytic, chronic, off-label use

Author notes

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Asterisk with author names denotes non-ASH members.

© 2011 by The American Society of Hematology
2011
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