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2014, Number 3

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Rev Hematol Mex 2014; 15 (3)

Low-dose carfilzomib induced a dramatic response of the symptoms and paraproteinemia in a heavily pre-treated multiple myeloma patient refractory to lenalidomide-bortezomib-dexametasone

Ruiz-Delgado GJ, Vallejo-Villalobos MF, Galindo-Becerra S, Ruiz-Argüelles GJ

Language: English
References: 15
Page: 137-141
PDF size: 433.22 Kb.


ABSTRACT

Carfilzomib is a novel proteasome inhibitor, structurally and mechanistically distinct from bortezomib, which has been shown to be useful in the management of relapsed and/or refractory patients with multiple myeloma (MM), its recommended dose being 27 mg/m2 biweekly. This paper reports the case of a 55-year-old female patient with IgA kappa MM who had been treated sequentially with thalidomide, dexametasone, bortezomib, lenalidomide and cyclophosphamide. She had become refractory to the combination of bortezomib, dexametasone and lenalidomide. She was given treatment with a reduced dose (50%) of carfilzomib, 27 mg/m2 once a week. Along a 4-week period, the paraproteinemia dropped from 2.9 to 0.5 g/dL and the symptoms disappeared. A reduced dose of carfilzomib (50%) was able to induce a significant clinical and response in a patient with mieloma múltiple heavily pre-treated and who had become refractory to bortezomiblenalidomide- dexametasone. Studies are needed to analyze if reduced doses of the drug, associated with diminished costs, are appropriate in the treatment of this disease. This information is critical in conditions of economic restrains.


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