The proposed mode of action of lenalidomide. Binding of lenalidomide to cereblon induces p21WAF1/Cip1 upregulation and cell cycle arrest in CLL cells. Thus far, it is not clear whether ubiquitination and degradation of the transcription factors IKZF1 and 3, as described for multiple myeloma, are involved in the effects of lenalidomide on CLL cells and their microenvironment. Professional illustration by Xavier Studio.
