Adam Sperling, MD, PhD, Dana-Farber Cancer Institute, Boston, MA, comments on the results of a study investigating the relationship between the genetics of therapy-related myeloid neoplasms and prior chemotherapy exposure. The study showed that prior lenalidomide exposure was associated with TP53-mutated acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS). Experiments on animal models showed that this was due to lenalidomide-induced casein kinase degradation. Therefore, using lenalidomide analogs such as thalidomide or iberdomide that do not degrade casein kinase could represent a safer treatment option in multiple myeloma. This interview took place at the European Hematology Association (EHA) Congress 2022 held in Vienna, Austria.