How does lenalidomide binding to cereblon produce cytotoxic and immunomodulatory effects in haematopoietic cells?

In haematopoietic cells, lenalidomide binds directly to cereblon within a cullin ring E3 ubiquitin ligase complex, recruiting the lymphoid transcription factors Aiolos and Ikaros for ubiquitination and subsequent degradation, thereby producing direct cytotoxic and immunomodulatory effects.