Carfilzomib-induced thrombotic microangiopathy (TMA): an under-recognised spectrum of disease from microangiopathic haemolysis to subclinical TMA

Ponraj, Royston; Bryant, Adam; Dunlop, Lindsay; Rangé, Hélène; Cobrador, Cherry; Ling, Silvia; Hsu, Danny C.

doi:10.1038/s41408-023-00885-9

Blood Cancer J.

2023

DOI: 10.1038/s41408-023-00885-9

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Carfilzomib-induced thrombotic microangiopathy (TMA): an under-recognised spectrum of disease from microangiopathic haemolysis to subclinical TMA

Royston Ponraj

Adam Bryant

Lindsay Dunlop

et al.

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Cited by 6 publications

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Carfilzomib-induced thrombotic microangiopathy (TMA) refractory to eculizumab: A case report and literature review

Meseha,

Qu,

Lykon

et al. 2024

Ann Hematol

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This case report describes the clinical course of a patient with relapsed IgA kappa multiple myeloma with high-risk cytogenetics. Initially treated with daratumumab–bortezomib–lenalidomide–dexamethasone (Dara-VRD) then transitioned to lenalidomide maintenance. However, he experienced a relapse and was treated with carfilzomib-based therapy (CFZ) but developed drug-induced thrombotic microangiopathy (DI-TMA). Despite receiving eculizumab and supportive care, the patient's condition worsened, leading to encephalopathy and refractory gastrointestinal bleeding in the setting of persistent thrombocytopenia. Ultimately, the decision was made to transition to comfort-focused care. DI-TMA has been documented with various proteasome inhibitors such as ixazomib and bortezomib. Additionally, other medications such as cyclosporine, tacrolimus, clopidogrel, ticlopidine, and interferon have been associated with DI-TMA as well (Pisoni et al. (Drug Saf 24:491–501, 2001) [18]). Here we discuss a case of carfilzomib-induced TMA (CFZ-TMA) refractory to eculizumab as well as a review of the published literature.

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Carfilzomib-induced thrombotic microangiopathy (TMA) refractory to eculizumab: A case report and literature review

Meseha,

Qu,

Lykon

et al. 2024

Ann Hematol

View full text Add to dashboard Cite

show abstract

Carfilzomib

2023

Reactions Weekly

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Proteasome inhibitors related thrombotic microangiopathy: a systematic and comprehensive review

Chen,

Li,

Shi

et al. 2024

Blood Cancer J.

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Carfilzomib-induced thrombotic microangiopathy (TMA): an under-recognised spectrum of disease from microangiopathic haemolysis to subclinical TMA

Cited by 6 publications

References 14 publications

Carfilzomib-induced thrombotic microangiopathy (TMA) refractory to eculizumab: A case report and literature review

Carfilzomib-induced thrombotic microangiopathy (TMA) refractory to eculizumab: A case report and literature review

Carfilzomib

Proteasome inhibitors related thrombotic microangiopathy: a systematic and comprehensive review

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