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Restoration of chemosensitivity by bortezomib: implications for refractory myeloma

Nature Reviews Clinical Oncology volume 6, pages 237–240 (2009)Cite this article

Abstract

Background. A 59-year-old woman presented to the emergency department with a left rib fracture and was diagnosed with IgA multiple myeloma. The patient underwent autologous bone-marrow transplantation, and 14 months later she developed obstructive jaundice.

Investigations. Serum protein electrophoresis, contrast CT of thorax and abdomen, endoscopic retrograde cholangiopancreatography with endoscopic biopsy and pleural biopsy.

Diagnosis. Extramedullary plasmacytomas at pancreatic head and pleura.

Management. Salvage chemotherapy regimens including bortezomib plus steroid, alkylators plus steroid, bortezomib plus anthracycline and radiotherapy, and combined bortezomib, cyclophosphamide, melphalan and steroid therapy.

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Figure 1: Diagram showing IgA levels in relation to events during the patient's treatment.
Figure 2: CT images of the patient showing the extramedullary relapses.

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Acknowledgements

Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, Hong Kong

    Chor Sang Chim & Yu Yan Hwang

  2. Department of Radiology, Queen Mary Hospital, Hong Kong

    Clara Pang

  3. Department of Pathology, Queen Mary Hospital, Hong Kong

    Tony W. Shek

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  1. Chor Sang Chim
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  2. Yu Yan Hwang
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Correspondence to Chor Sang Chim.

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Chim, C., Hwang, Y., Pang, C. et al. Restoration of chemosensitivity by bortezomib: implications for refractory myeloma. Nat Rev Clin Oncol 6, 237–240 (2009). https://doi.org/10.1038/nrclinonc.2009.15

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