[Successful Treatment with Pomalidomide, Bortezomib, and Dexamethasone in a Patient with Frail Refractory and Relapsed Multiple Myeloma with Extramedullary Disease].

Abstract

An 85-year-old female was diagnosed with multiple myeloma(MM)(IgG-l)with t(4 ;14)(p16;q32)in 200X. She received bortezomib with dexamethasone(Vd)therapy and lenalidomide with dexamethasone(Ld)therapy, and she subsequently maintained a very good partial response(VGPR). On day 731, she experienced relapse and was treated with 2 courses of elotuzumab with Ld therapy. However, on day 794, she experienced relapse with plasmacytoma, and was treated with 2 courses of pomalidomide and low-dose dexamethasone(Pd), 2 courses of cyclophosphamide with Pd(PCd), and bortezomib with Pd(PVd)therapies. After 3 courses of PVd therapy, she achieved PR. She has continued to receive 11 courses of PVd therapy and has not suffered any adverse events(BGrade 3). These findings suggest that PVd therapy is a relatively safe and highly efficacious treatment for frail patients with relapsed and refractory MM who have previously received both lenalidomide and bortezomib. Further studies are needed to establish treatment efficacy and safety in frail patients with relapsed and refractory MM with extramedullary disease.

• Authors: Satoko Oka, Suguru Takeuchi, Hiroshi Shiragami, Yayoi Shimazu, Yutaka Shimazu, Masaharu Nougawa
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 45 Issue 12 Pg. 1779-1782 (Dec 2018) ISSN: 0385-0684 [Print] Japan
• PMID: 30587741 (Publication Type: Case Reports, Journal Article)

Chemical References

• Thalidomide
• Bortezomib
• Dexamethasone
• pomalidomide

Topics

• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bortezomib (administration & dosage)
• Dexamethasone (therapeutic use)
• Female
• Humans
• Multiple Myeloma (drug therapy)
• Neoplasm Recurrence, Local
• Thalidomide (administration & dosage, analogs & derivatives)
• Treatment Outcome