Relapsed Multiple Myeloma Presenting as Intracranial Plasmacytoma and Malignant Pericardial Effusion following Recent Allogeneic Stem Cell Transplantation

Pan, Jingbo; Chen, Jason; Filicko, Joanne; Grosso, Dolores; Nagurney, Michelle; Alpdoğan, Önder; Flomenberg, Neal

doi:10.1159/000478001

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…This patient was initially treated with one cycle of lenalidomide and dexamethasone in addition to radiation therapy. 5 She subsequently underwent four cycles of lenalidomide, bortezomib and dexamethasone, but had progression of her osseous lesions. She was then treated with three cycles of carfilzomib, lenalidomide and dexamethasone, followed by an allogeneic stem cell transplant.…”

Section: Discussionmentioning

confidence: 99%

Pericardial relapse of multiple myeloma

Jamison

Kwok

2020

BMJ Case Rep

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In patients who experience relapse of multiple myeloma, upwards of 30% can have extramedullary disease. The presence of extramedullary multiple myeloma is typically associated with adverse cytogenetics and a poor prognosis. Organs most commonly involved include the liver, skin, central nervous system, pleural effusions, kidney, lymph nodes, and pancreas. We present the case of a 53-year-old man with IgA kappa multiple myeloma with the adverse cytogenetic findings of t(4;14) and 1q21 gain who had achieved a stringent complete (sCR) response after initial therapy with carfilzomib, lenalidomide and dexamethasone. Stringent complete response is defined as the normalization of the free light chain ratio in the serum and an absence of clonal cells in the bone marrow in additiion to criteria needed to achieve complete response. Prior to undergoing a planned autologous stem cell transplant, this patient experienced cardiac tamponade secondary to extramedullary relapse of his multiple myeloma which was limited to the pericardium. In response, his treatment regimen was transitioned to pomalidomide, bortezomib, dexamethasone and cyclophosphamide for three cycles after which he again achieved sCR and ultimately underwent autologous stem cell transplant. Post-transplant consolidation therapy was administered in the form of pomalidomide, bortezomib and dexamethasone, followed by pomalidomide and bortezomib maintenance, which he has continued to receive for 3 years without evidence of disease progression.

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Section: Discussionmentioning

confidence: 99%

Pericardial relapse of multiple myeloma

Jamison

Kwok

2020

BMJ Case Rep

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“…2 Although it has been reported in the literature (approximately 27 cases between 1970 to 2019), malignant pericardial effusion from multiple myeloma is relatively uncommon. 3,4 In addition, a rare but known complication of poorly controlled multiple myeloma is hyperviscosity syndrome, which typically presents as spontaneous hemorrhage of the mucosal membranes, headaches or neurological symptoms. We present a case of a patient with multiple myeloma who was found to have a pericardial effusion with tamponade that was also complicated by hyperviscosity syndrome.…”

Section: Introductionmentioning

confidence: 99%