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Does Lenalidomide Treatment Impact Apoptosis in CLL? Research Study Suggests Perhaps

By: Kayci Reyer
Posted: Monday, July 26, 2021

According to research presented in Hematological Oncology, the immunomodulatory agent lenalidomide may cause apoptosis of chronic lymphocytic leukemia (CLL) cells, despite having a limited effect on bone marrow stromal cells. Gábor Barna, PhD, of Semmelweis University in Budapest, and colleagues found that lenalidomide use resulted in the cells becoming more immunogenic and less responsive to bone marrow stromal cell survival signals.

The study included two groups of CLL cells: those cultured alone and those cultured with bone marrow stromal cells. Both groups were treated with lenalidomide and evaluated for apoptosis, immunophenotype, and cytokine secretions using flow cytometry. As a result of lenalidomide treatment, CLL cells experienced a mild increase in apoptosis, evading the antiapoptotic effect typically produced by bone marrow stromal cells, and a decrease in antigen expression.

The expressions of IRF4 and CD86, a co-stimulatory molecule, were more pronounced following treatment. No impact was observed on cytokine secretion. Overall, CLL cells that were CD49d-negative had a stronger response to lenalidomide treatment.

“Here, we prove for the first time that CD49d-negative cells are more sensitive to the proapoptotic and immunomodulatory effects of lenalidomide,” concluded the study authors. “Thus, such cases may respond better to lenalidomide treatment and are the optimal candidate[s] for this therapy.”

Disclosure: The study authors reported no conflicts of interest.

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