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. 2019 Feb 14;185(2):240–253. doi: 10.1111/bjh.15797

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© 2019 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Complementary mechanisms of lenalidomide and rituximab induce immune‐mediated cytotoxicity in FL tumour cells. Lenalidomide single‐agent resulted in increased Natural Killer (NK)cell (orange) and T cell (blue) activation and proliferation and enhanced immune synapse formation, leading to apoptosis of follicular lymphoma (FL) cells (grey). Rituximab treatment of target FL cells led to NK cell–mediated antibody‐dependent cellular cytotoxicity (ADCC) of FL cells. Combining lenalidomide with rituximab resulted in enhancement of tumour apoptosis through complementary mechanisms.