Lenalidomide-Associated Immune Thrombocytopenia: A Case Report and Review of the Literature

Table 1

A comparison of the cases of lenalidomide-associated ITP reported in the literature along with our case.

	Case 1[10]	Case 2 [10]	Case 3 [10]	Case 4 [10]	Case 5 [8]	Case 6 [9]	Our case
Age	66	76	78	66	27	74	59
Sex	F	F	F	F	M	F	M
Plasma cell dyscrasia subtype	IgGk MM	IgGλ MM	IgAλ amyloid	MM (subtype not reported)	MM (subtype not reported)	Light chain λ MM	IgGλ MM
Dose of len	15 mg	15 mg	15 mg	25 mg	25 mg	15 mg	10 mg
Previous autologous bone marrow transplant	No	No	No	No	Yes	No	Yes
Cycle of lenalidomide before developing thrombocytopenia	5	3	6	3	Received consolidation × 4 VRD and maintenance lenalidomide × 3 months	1	1
Treatment of ITP	Steroids, IVIg, rituximab	Steroids	Steroids	Steroids (prednisone)	Steroids and IVIG	Steroids	Steroids, IVIg, rituximab, splenectomy
Persistent thrombocytopenia after stopping lenalidomide	Yes	Yes, until steroids initiated. Responded to steroids at around 1 month after stopping lenalidomide	Yes, patient remained steroid-dependent	Yes	No, responded to steroid tapering	No, responded to steroid tapering	Yes, patient eventually obtained a long-term remission with splenectomy
Retreatment with lenalidomide was associated with recurrence of thrombocytopenia	Yes	Retreated, but no recurrent thrombocytopenia	Not retreated	Not retreated	Not retreated	Not retreated	Not retreated
Other manifestations	None reported	None reported	None reported	None reported	Alopecia, leukopenia	Rash, proteinuria	None