Bortezomib overcomes the negative prognostic impact of renal impairment in a newly diagnosed elderly patient with multiple myeloma: A case report

Abstract

Multiple myeloma (MM) is a common B-cell hematological malignancy in the clinic. Bortezomib is the first-in-class proteasome inhibitor that has been approved for the treatment of patients with MM in the bone marrow. The present study report the case of an 83-year-old man who showed marked weakness, fatigue and a poor appetite. The patient was admitted to the Department of Nephrology due to severe renal impairment (RI). Immunofixation electrophoresis indicated a λ light chain-positive status. There were 19.2% plasmablasts and proplasmacytes in the bone marrow. Positivity for the cell surface markers cluster of differentiation (CD)13, CD33, CD38 and human leukocyte antigen-antigen D-related was detected by flow cytometry. The patient was diagnosed with MM, λ light chain type, stage IIIB, and received bortezomib and dexamethasone regimen chemotherapy. RI was improved following the chemotherapy, and plasmablasts and proplasmacytes were almost eliminated. The Hb level was maintained at ~90 g/l. Overall, the present case report suggests that bortezomib may be safe and effective for elderly patients, even those >80 years of age, with severe RI.

Mechanisms underlying the increased chemosensitivity of bortezomib-resistant multiple myeloma by silencing nuclear transcription factor Snail1

“…The 2008 National Comprehensive Cancer Network (NCCN) guideline listed bortezomib single-drug and its combination with liposomal doxorubicin as the category I preferred regimen and bortezomib + dexamethasone as the category 2A preferred regimen (15). As the first-line drug for MM treatment, bortezomib has its own advantages (16). Although the chemotherapy regimen based on bortezomib significantly improves the related symptoms of MM patients within a short time period and delays tumor progression, almost all MM patients with bortezomib administration exhibit drug resistance features after bortezomib medication for a period of time, which greatly limits the long-term efficacy of bortezomib in MM (17).…”

Monocyte, Neutrophil, Eosinophil and Lymphocyte Volume Levels in Multiple Myeloma Patients

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.Monocyte, neutrophil, eosinophil and lymphocyte volume levels in multiple myeloma patients M ultiple Myeloma (MM) is a malignant plasma cell structure disorder that gives rise to approximately 10% hematological malignancy [1]. MM is malignant proliferation that still occurs as a result of the uncontrolled growth of white blood cell monoclonal plasma cells [2][3][4]. Bone ion or monoclonal protein in urine and/or serum is diagnosed by clonal plasma cells [5].

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“…Patients with MM have a high amount of protein in their blood. Antibody-producing plasma cells (immunoglobulin) can be expressed as cells that destroy the effects of immune reactions and pressurized), which has a significant role in the immune system, which balances the T cell's responses to the tumor cells [2,9]. Monocytes are the precursors of dendritic cells (DC).…”