Lenalidomide can be highly effective in chronic lymphocytic leukaemia despite T-cell depletion and deletion of chromosome 17p.

Lenalidomide is an immunomodulatory agent with activity in a range of haematological cancers including chronic lymphocytic leukaemia (CLL). However, major questions remain concerning its effectiveness in patients with T-cell depletion or deletion of TP53 on chromosome 17p. This case report provides insight into these questions by showing that lenalidomide/dexamethasone in combination can be highly effective as induction therapy for refractory 17p-CLL, that remission quality can be improved by subsequent maintenance with lenalidomide alone and that the anti-leukaemic effects of lenalidomide and its stimulatory effects on non-malignant B cells are preserved despite prolonged T-cell depletion resulting from prior alemtuzumab/methylprednisolone.