Bortezomib
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Congestive heart failure: case report A 50-year-old woman developed severe congestive heart failure (CHF) following treatment with bortezomib for stage IIIB multiple myeloma. The woman received two cycles of chemotherapy comprising bortezomib 1.3 mg/m2 [route not stated] on days 1, 4, 8 and 11 of each 3-week cycle, alongside lowdose dexamethasone. After completion of the second cycle of therapy, she reported fatigue, orthopnoea, dyspnoea, and lower extremity oedema but no chest pain or myalgia. Chest x-ray showed an increased heart-chest ratio and mild signs of pulmonary vasculature congestion. Troponin and CK-MB levels were not elevated. Echocardiogram showed decreased left ventricular ejection fraction (LVEF) of < 10%–15%. She was diagnosed clinically with CHF. Chemotherapy was discontinued and the woman was treated initially with furosemide. She subsequently underwent heart catheterisation confirming a diagnosis of New York Heart Association (NYHA) class III CHF. Standard interventional therapy post CHF led to further improvement of symptoms and she was subsequently discharged. Echocardiogram 1 month after initial diagnosis showed her LVEF had improved to 30%. Author comment: "We hypothesize that the cardiomyopathy in our patient was induced by Bortezomib through inhibition of the ubiquitin-proteasome system." Jerkins JH, et al. Bortezomib-induced Severe Congestive Heart Failure. Cardiology Research 1: 20-23, No. 1, Dec 2010. Available from: URL: http:// 803072354 dx.doi.org/10.4021/cr105e - USA
0114-9954/10/1407-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 23 Jun 2012 No. 1407
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