Lenalidomide is a second generation immunomodulatory agent (IMiD), which currently represents the standard of care for
treatment of transfusion dependent lower risk myelodysplastic syndrome (MDS) patients with deletion (5q). Lenalidomide has unique activity
with a high transfusion independence rate observed in this subset of patients. In this article we summarize the clinical experience
using lenalidomide for treatment of del (5q) MDS. We highlight the mechanism of action and the recent advances in understanding the
biology of del (5q) MDS. We also explore its potential use and the efforts to further improve its activity in non-del (5q) MDS.
Keywords: Lenalidomide, myelodysplastic syndromes, deletion 5q, non-del(5q), immunomodulatory agent (IMiD), bone marrow failure, anemia, cytokines, apoptosis, myeloblast
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