Treatment of relapsed multiple myeloma complicated by cardiac extramedullary plasmacytoma with D-PACE chemotherapy

Abstract

Cardiac extramedullary plasmacytomas (EMPs) are rare and may be a seen as a complication of multiple myeloma (MM) or in isolation. Here, we describe a case of cardiac EMP that presented clinically as a congestive heart failure exacerbation in a patient with relapsed and refractory IgG lambda MM. We highlight radiographic imaging in conjunction with laboratory biomarkers at presentation and in response to D-PACE (dexamethasone, cisplatin (Platinol), doxorubicin (Adriamycin), cyclophosphamide and etoposide) systemic chemotherapy.

Molecular Profiling Practices in Pancreatic Adenocarcinoma: Academic vs Community Physicians

“…Notably, the incidence of HFSR from a specific MKI can vary among tumor types, as different doses might be indicated for them. 1,10,11 HFSR has several risk factors. In a meta-analysis of randomized controlled trials involving 24,956 patients, the CORRECT ANSWER: D. High-potency topical steroid (ie, clobetasol propionate 0.05% ointment) plus a keratolytic agent (ie, urea 40% cream).…”

“…The patient must be free of limiting rectal pathology that would preclude use of a transrectal probe for delivery. Large glands >40 g may be a contraindication for HIFU using some older devices, as the focal length may not 11 Anterior lesions treated with primary HIFU have been shown to require additional treatment at a higher rate than posterior lesions, as the penetration depth of the ultrasound energy is limited. 12 Widespread calcifications may also be a limitation; they can cause acoustic shadowing, which does not allow passage of the therapeutic sound waves.…”

Treatment Options for Triple-class Refractory Multiple Myeloma

“…However, because toxicity has been common and the PFS short, D(T)-PACE has generally been considered most effective when used as a bridge to other MM treatment interventions. 21 Similarly, high-dose cyclophosphamide has shown value as a potential bridge to novel therapies in refractory MM. When used in combination with dexamethasone, high-dose cyclophosphamide was shown to be an efficient rescue regimen for patients with doublerefractory MM, with an overall response rate (ORR) of 55%, with 3 patients (15%) achieving a complete response (CR).…”

Masa septal interauricular: más allá de la hipertrofia lipomatosa

“…La enfermedad plasmocítica cardíaca conlleva un pronóstico reservado, con una supervivencia del 50% a los 15 meses desde el diagnóstico (3) .…”