Case Study in 2010

A 63-year-old woman with chronic myeloid leukemia who achieved a complete cytogenic response after 6 years of interferon-alpha went on to lose molecular response 2 years after treatment cessation. In this Case Study, Monica Bocchia and colleagues demonstrate the positive outcome in this patient following treatment with a therapeutic vaccine that consists of the p210 BCR–ABL1-derived peptide. The patient has maintained a complete molecular response for over 39 months.

A 63-year-old male patient under chronic treatment with sorafenib for an unresectable multifocal hepatocellular carcinoma (HCC) presented with suspected variant angina. Spontaneous spasm occurred during cardiac catheterization and was revealed during coronary angiogram with the unusual feature of a retrograde transient filling of a contralateral branch. Italo Porto and colleagues contend that the effects of sorafenib treatment were primarily responsible for the major cardiovascular event observed in this case, and suggest that clinicians should be aware of this possible severe complication of sorafenib therapy.

This Case Study describes a patient with multiple relapses of atypical HLH that became refractory to treatment with numerous immunosuppressive agents. As HLH is driven by CD52⁺T cells and histiocytes, alemtuzumab was used as targeted therapy to induce stable remission and enable allogeneic stem-cell transplantation to be successfully performed.

This Case Study describes a patient with multiple myeloma and renal impairment who developed acute renal failure after three cycles of bortezomib-based primary therapy. Second-line lenalidomide and dexamethasone, with lenalidomide dose adjustment according to the patient's renal function, was well tolerated. This therapy elicited a rapid, durable partial tumor response and prompt improvement in the patient's kidney function.

A 71-year-old male patient was diagnosed with aKIT-positive gastrointestinal stromal tumor (GIST). The patient received adjuvant imatinib but developed several subcutaneous and intra-abdominal tumor lesions after 4 months of treatment. A T-cell lymphoproliferative disorder was suspected. The authors discuss the potential of imatinib to induce reversible clonal T-cell proliferations in patients with GIST who develop new tumor manifestations that are suspicious for relapse.

This Case Study describes a patient with breast cancer who was treated with capecitabine and experienced a severe adverse event when treated with brivudin for a herpes infection. The authors discuss drug–drug interactions and management of the associated toxic effects.