Abstract

Recently, the prognosis of multiple myeloma has been improved by using high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT), bortezomib, and immunomodulatory drugs including thalidomide and lenalidomide. On the other hand, treatment strategy remains difficult for refractory and relapse cases. Here, we report the successful treatment of low-dose lenalidomide maintenance therapy followed by salvage ASCT in a heavily treated patient with multiple myeloma. This 58-year-old woman with IgG-λ multiple myeloma had a 5th recurrence in June, 2011. It was 7 years post-diagnosis, and she had received conventional therapies such as VAD, MP therapy. Furthermore, the patient had already been treated with ASCT, bortezomib, and thalidomide therapy. At the 5th recurrence, she had extramedullary plasmacytoma in the left orbit. She initially received bortezomib and dexamethasone therapy as induction therapy. After peripheral blood stem cell collection, radiation therapy was performed. The patient then received a second ASCT. Three months later, the response was very good partial response. Finally, the patient was treated with 5 mg/day lenalidomide orally as a maintenance therapy, and she achieved stringent complete response after 2 months according to International Myeloma Working Group response criteria. Low-dose lenalidomide maintenance therapy might be also useful for ASCT as salvage therapy, although further studies are warranted.

Highlights

  • Myeloma survival has markedly improved by high-dose chemotherapy with autologous peripheral blood stem cell transplantation (ASCT) in young patients [1,2]

  • The prognosis of multiple myeloma has been improved by using high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT), bortezomib, and immunomodulatory drugs including thalidomide and lenalidomide

  • We report here a case of successful treatment of heavily treated myeloma patient with low-dose lenalidomide maintenance therapy after second ASCT as salvage therapy

Read more

Summary

Introduction

Myeloma survival has markedly improved by high-dose chemotherapy with autologous peripheral blood stem cell transplantation (ASCT) in young patients [1,2]. Novel agents such as bortezomib, and immunomodulatory drugs have been recently become available [2]. One of the choices of salvage therapy is ASCT, which has been reported useful and safe [3,4,5]. Some reports are available using novel agents after relapse or progression after frontline therapy including ASCT [6,7]. We report here a case of successful treatment of heavily treated myeloma patient with low-dose lenalidomide maintenance therapy after second ASCT as salvage therapy

Case Report
Discussion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.