5q- syndrome and multiple myeloma diagnosed simultaneously and successful treated with lenalidomide

Leuk Res. 2013 Oct;37(10):1248-50. doi: 10.1016/j.leukres.2013.06.021. Epub 2013 Jul 26.

Abstract

A 72-year-old woman was diagnosed with 5q- myelodysplastic syndrome in the course of an indolent multiple myeloma (MM). Bone marrow (BM) cytogenetics disclosed two unrelated clones: 46,XX,del(5)(q13q33), and [47,X,-X,der(1;21)(q10;q10),-4,-4,+5,del(5)(q13q31),+7,der(7)t(1;7)(p34.2;p22),add(8)(p23),-13,+15,der(16) t(1;16)(q23;q12.2),+19,-21,+mar1,+mar2]. The last complex karyotype belonged to malignant plasma cells. FISH and SKY techniques demonstrated different 5q deletions. EGR1 gene (on 5q31) lost in 5q- syndrome remained in 5q- plasma cells. Biclonal evolution was noted: myeloid 5q- cells added a deletion 13q and plasma cells showed monosomy 13. Patient achieved complete cytogenetic response of 5q- syndrome with low-dose of lenalidomide, and a partial remission of MM with high-dose of lenalidomide/dexamethasone combination.

Keywords: 5q−; BM; Lenalidomide; Multiple myeloma; SKY; Unrelated clones.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormal Karyotype
  • Aged
  • Anemia, Macrocytic / complications*
  • Anemia, Macrocytic / diagnosis
  • Anemia, Macrocytic / drug therapy*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chromosome Banding
  • Chromosome Deletion
  • Chromosomes, Human, Pair 5
  • Female
  • Humans
  • Lenalidomide
  • Multiple Myeloma / complications*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Thalidomide / administration & dosage
  • Thalidomide / analogs & derivatives*
  • Thalidomide / therapeutic use
  • Treatment Outcome

Substances

  • Thalidomide
  • Lenalidomide

Supplementary concepts

  • Chromosome 5q Deletion Syndrome