Description:
Myelodysplastic Syndrome (MDS) with del(5q) represents a unique WHO entity, which isoften treated with lenalidomide according to standard clinical practice. Guidelinesconcerning treatment duration have thus far not been implemented, but rathercomprise an indefinite therapy until loss of response. This review presents three redblood cell (RBC) transfusion-dependent MDS with del(5q) cases, starting with one rarecase with an unbalanced translocation t(2;5), involving the breakpoint of del(5q) and lossof the 5q15-5q31 region. To the best of our knowledge, no comparable case has beendescribed before with a response to lenalidomide. Strikingly, treatment-induced andmaintained cytogenetic complete remission (cCR) in this patient. Furthermore, we reporttwo cases of classical del(5q), in which lenalidomide was interrupted after a short period oflenalidomide therapy at the time cCR was achieved. Despite drug holiday cCR wasmaintained for seven and nine years, respectively. Then del(5q) re-emerged in theabsence of novel molecular aberrations and re-treatment with lenalidomide could againachieve cCR in both cases. Together, this series presents three cases of personalizedtherapy of MDS with del(5q)