Low-dose carfilzomib induced a dramatic response of the symptoms and paraproteinemia in a heavily pre-treated multiple myeloma patient refractory to lenalidomide-bortezomib-dexametasone

Autores: Ruiz Delgado Guillermo J, Vallejo Villalobos María Fernanda, Galindo Becerra Samantha, Ruiz Argüelles Guillermo José

Resumen

Carfilzomib is a novel proteasome inhibitor, structurally and mechanistically distinct from bortezomib, which has been shown to be useful in the management of relapsed and/or refractory patients with multiple myeloma (MM), its recommended dose being 27 mg/m2 biweekly. This paper reports the case of a 55-year-old female patient with IgA kappa MM who had been treated sequentially with thalidomide, dexametasone, bortezomib, lenalidomide and cyclophosphamide. She hadbecome refractory to the combination of bortezomib, dexametasone and lenalidomide. She was given treatment with a reduced dose (50%) of carfilzomib, 27 mg/m2 once a week. Along a 4-week period, the paraproteinemia dropped from 2.9 to 0.5 g/dL and the symptoms disappeared. A reduced dose of carfilzomib (50%) was able to induce a significant clinical and response in a patient with mieloma multiple heavily pre-treated and who had become refractory to bortezomiblenalidomide-dexametasone. Studies are needed to analyze if reduced doses of the drug, associated with diminished costs, are appropriate in the treatment of this disease. This information is critical in conditions of economic restrains.

Palabras clave: Multiple myeloma treatment carfilzomib lenalidomide bortezomib dexametasone paraproteniemia.

2014-12-18   |   336 visitas   |   Evalua este artículo 0 valoraciones

Vol. 15 Núm.3. Julio-Septiembre 2014 Pags. 137-141 Rev Hematol 2014; 15(3)