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Case Reports
. 2017 Dec 22;28(4):217-220.
doi: 10.31138/mjr.28.4.217. eCollection 2017 Dec.

Rituximab and lenalidomide combination treatment for rheumatoid arthritis complicated with myelodysplastic syndrome: A case report

Gerasimos Evangelatos  1 , Ioanna Vlachadami  2 , Maria Kechagia  1 , Alexios Iliopoulos  1
Affiliations
Case Reports

Rituximab and lenalidomide combination treatment for rheumatoid arthritis complicated with myelodysplastic syndrome: A case report

Gerasimos Evangelatos et al. Mediterr J Rheumatol. .

Abstract

Rheumatoid arthritis patients might experience several hematologic complications. The development of myelodysplastic syndrome is not clearly associated with RA, even though it has been described in some patients with pre-existing disease. There are only few data available in the literature concerning the therapeutic approach of such patients. Herein, we report a case of RA complicated with progressive MDS, successfully treated with rituximab and lenalidomide combination therapy.

Keywords: lenalidomide; myelodysplastic syndrome; rheumatoid arthritis; rituximab.

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Figures

Figure 1.
Figure 1.
Hematocrit (Ht) and C-reactive protein (CRP) levels are demonstrated in correlation with time (patient’s visits at our department for the last 4 years). Secondary failure of adalimumab (ADA) led to treatment switch to tocilizumab (TCZ). Secondary failure of TCZ, in the context of progressively deteriorating anemia, resulted in TCZ discontinuation and initiation of lenalidomide (LEN). Following eleven months of LEN monotherapy, rituximab (RTX) treatment was initiated due to an arthritis flare. After four cycles (2 years) of RTX and LEN combination therapy, both anemia and joint inflammation are controlled.
See this image and copyright information in PMC

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