Abstract
Renal dysfunction is a common comorbidity of multiple myeloma. However, tumor lysis syndrome is a rare cause of renal dysfunction in multiple myeloma. Elotuzumab is a newly US FDA-approved monoclonal antibody used in the treatment of refractory multiple myeloma. To our knowledge, elotuzumab has not been associated with a case of tumor lysis syndrome. We present the case of a patient who developed clinical tumor lysis syndrome 1 week after treatment with elotuzumab accompanied by renal failure with hyperphosphatemia, hyperkalemia, and profound hyperuricemia. His course was further complicated by significant epistaxis from the accumulation of dabigatran in acute renal failure. In spite of treatment with rasburicase and hemodiafiltration, the patient decompensated and eventually died. Risk factors for the development of tumor lysis syndrome in multiple myeloma are discussed.
Highlights
Multiple myeloma (MM) is a clonal B-cell neoplasm that accounts for 10% of hematological malignancies [1]
We present the case of a patient who developed clinical tumor lysis syndrome 1 week after treatment with elotuzumab accompanied by renal failure with hyperphosphatemia, hyperkalemia, and profound hyperuricemia
We presented the case of a 61-year-old male with MM who presented with profound hyperuricemia and uricosuria, hyperkalemia, hyperphosphatemia, and acute renal failure within 1 week of starting elotuzumab therapy for MM
Summary
Multiple myeloma (MM) is a clonal B-cell neoplasm that accounts for 10% of hematological malignancies [1]. Tumor lysis syndrome is a rare cause of renal dysfunction in multiple myeloma. We present the case of a patient who developed clinical tumor lysis syndrome 1 week after treatment with elotuzumab accompanied by renal failure with hyperphosphatemia, hyperkalemia, and profound hyperuricemia.
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