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<p>Sickle cell anemia (SCA) and multiple myeloma (MM) are debilitating hematologic diseases impacting hemoglobin and plasma cells, respectively. Despite differing origins, they share overlapping clinical features including bone pain and anemia. A cornerstone of SCA is to induce fetal hemoglobin through hydroxyurea treatment. Lenalidomide, a central treatment of MM, has also been shown to induce fetal hemoglobin in vitro. Here we present a case of a young woman with SCA and subsequently multiple myeloma. When lenalidomide was used as part of multiple myeloma treatment, we investigated the proposed induction of fetal hemoglobin, using high-pressure liquid chromatography. Over a treatment period of 114 days, we did not observe lenalidomide-induced increases in fetal hemoglobin and were thereby unable to replicate in vitro findings. Moreover, the case highlights many difficulties of diagnosing and treating patients with SCA and concurrent malignancies.</p>

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Unexpected absence of fetal hemoglobin induction by lenalidomide in a patient with sickle cell anemia with concurrent multiple myeloma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月17日

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  • Rasmus Rønnemoes,
  • Jens Helby,
  • Amina Nardo-Marino,
  • Morten Hanefeld Dziegiel,
  • Jesper Petersen,
  • Agoston Gyula Szabo,
  • Nina Toft,
  • Andreas Glenthøj

摘要

Sickle cell anemia (SCA) and multiple myeloma (MM) are debilitating hematologic diseases impacting hemoglobin and plasma cells, respectively. Despite differing origins, they share overlapping clinical features including bone pain and anemia. A cornerstone of SCA is to induce fetal hemoglobin through hydroxyurea treatment. Lenalidomide, a central treatment of MM, has also been shown to induce fetal hemoglobin in vitro. Here we present a case of a young woman with SCA and subsequently multiple myeloma. When lenalidomide was used as part of multiple myeloma treatment, we investigated the proposed induction of fetal hemoglobin, using high-pressure liquid chromatography. Over a treatment period of 114 days, we did not observe lenalidomide-induced increases in fetal hemoglobin and were thereby unable to replicate in vitro findings. Moreover, the case highlights many difficulties of diagnosing and treating patients with SCA and concurrent malignancies.