Liver Involvement in Multiple Myeloma

Bhandari, Meghana; Mazumder, Amitabha

doi:10.3816/clm.2007.n.039

Cited by 28 publications

(18 citation statements)

References 13 publications

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“…Similarly, hepatic impairment (HI) either due to disease or therapy-related effects may require appropriate dosing of these drugs [8]. Disease-related HI may be due to plasmacytomas, sinusoidal infiltration, amyloid infiltration, light-chain deposition or thrombosis [8,9].…”

mentioning

confidence: 99%

“…Disease-related HI may be due to plasmacytomas, sinusoidal infiltration, amyloid infiltration, light-chain deposition or thrombosis [8,9]. Therapy-related HI may be directly caused by various drugs or indirectly as in the cases of viral hepatitis, cytomegalovirus infection and graft-versus-host or veno-occlusive disease in patients who have undergone stem cell transplantation.…”

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confidence: 99%

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The use of Novel Agents in Multiple Myeloma Patients with Hepatic Impairment

2015

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Novel drugs such as immunomodulators and proteasome inhibitors have improved the survival of patients with multiple myeloma. Like all therapeutic agents, appropriate dosing based on metabolism and clearance is important to maintain efficacy while avoiding toxicity. Hepatic impairment (HI) in multiple myeloma patients is rare but well described either due to disease or therapy-related factors. However, limited data are available on the appropriate use and dosing of the novel agent therapeutics in myeloma patients with HI. Furthermore, data on HI secondary to the novel agent toxicity are also sparse. This systematic review highlights the evidence on the use of novel agents like thalidomide, lenalidomide, pomalidomide, bortezomib and carfilzomib in patients with HI as well as their associated hepatic toxicities.

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confidence: 99%

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confidence: 99%

The use of Novel Agents in Multiple Myeloma Patients with Hepatic Impairment

2015

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“…Multiple liver tumors of plasma cell myeloma are rare (1), and there is currently no consensus on the recommended treatment (2). In the present case, lenalidomide therapy was effective for treating multiple myeloma.…”

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confidence: 66%

Multiple Myeloma Mimicking Liver Metastases

Okamoto

Ueda

2015

Intern. Med.

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A 72-year-old man presented at our hospital with a onemonth history of abdominal pain.Abdominal computed tomography showed multiple tumors of the liver, and cancer metastasis was suspected (Picture 1).Magnetic resonance imaging confirmed the liver tumor findings, paravertebral mass and spinal bone lesion, which suggested multiple spinal bone metastases (Picture 2, 3). Histologically, a core needle biopsy of the liver tumor showed IgG-lambda positive plasma cells with a large-scale nucleus (Picture 4), and the serum IgG-lamda M protein level was 4.79 g/dL.Bone marrow aspiration revealed 25.8% atypical plasma cells, indicative of plasma cell myeloma. Combined bortezomib and dexamethasone therapy was commenced, but the disease progressed, and therapy was changed to lenalidomide and dexamethasone.After three cycles of therapy, the liver tumors showed a marked regression, and the M protein levels decreased.Multiple liver tumors of plasma cell myeloma are rare (1), and there is currently no consensus on the recommended treatment (2). In the present case, lenalidomide therapy was effective for treating multiple myeloma. The authors state that they have no Conflict of Interest (COI). References 1.Weinstock M, Ghobrial IM. Extramedullary multiple myeloma.

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“…Plasma cell infiltration of the liver in multiple myeloma can be histologically classified into diffuse (9)(10)(11)(12) or nodular forming pattern (3)(4)(5)(6)(7)(8) …”

Section: Discussionmentioning

confidence: 99%

“…Although plasma cell infiltration of the liver is detected in about 40% of patients with multiple myeloma at autopsy (2), it is rarely detected in living patients. Plasma cell infiltration of the liver in multiple myeloma can manifest as a nodular (3)(4)(5)(6)(7)(8) or diffuse infiltration pattern (9)(10)(11)(12). (Fig.…”

Section: Introductionmentioning

confidence: 99%