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Table 1 Differences between thalidomide, lenalidomide and pomalidomide

From: Mechanism of action of lenalidomide in hematological malignancies

Name Thalidomide Lenalidomide Pomalidomide
Empirical Formula C13H10N2O4 C13H13N3O3 C13H11N3O4
Molecular weight 258.2 259.3 273.2
Chemical Structural Thalidomide has two oxo groups in Phthaloyl ring Lenalidomide has amino group at 4th position and single oxo group in Phthaloyl ring Pomalidomide has amino group at 4th position and two oxo groups in Phthaloyl ring
Effects on T-cell proliferation Thalidomide stimulates T cell proliferation and increases IFN-γ and IL-2 production Lenalidomide is 100–1000 times more potent in stimulating T cell proliferation and IFN-γ and IL-2 production than thalidomide Pomalidomide is similar to lenalidomide, in addition, it also enhances transcription factor T-bet, which reverts Th2 cells into Th1 like effector cells in vitro
Adverse Effects Thalidomide has higher incidence of side effects like sedation, neuropathy and constipation. Lenalidomide has lower incidence of adverse effects namely sedation, constipation and neuropathy than thalidomide. Pomalidomide has lower incidence of adverse effects like sedation, constipation and neuropathy than thalidomide.
Teratogenecity Thalidomide is a known teratogen. Lenalidomide is not teratogenic in rabbit models Pomalidomide is a known teratogen.