UC Irvine

A 67-year-old male received an HLA matched unrelated peripheral blood stem cell transplant after a non-myeloablative conditioning regimen for heavily pretreated refractory chronic lymphocytic leukemia (CLL) in partial remission. His disease relapsed on day +90 post-transplant with persistent 100% engraftment of the donor cells. Immunusuppression was tapered off by day +96 and he was started on lenalidomide 10 mg per day on day +126. After 6 doses he acutely developed severe hepatitis potentially attributed to the lenalidomide mediated graft-versus-host disease. His liver enzymes slowly improved after cessation of lenalidomide and he achieved complete remission (CR) of the CLL without further treatment, presumably attributed to the graft-versus-leukemia effect induced by lenalidomide. He is alive and in CR over four years after the transplant with no additional therapy.