Bortezomib
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Bortezomib Diarrhoea, thrombocytopenia, neuropathy and renal failure: 7 case reports
Seven patients developed grade III-IV diarrhoea during treatment with bortezomib for multiple myeloma; some patients also experienced neuropathy, with or without thrombocytopenia, or renal failure [see table for patient details].
Patient details Patient/ sex/age (y)
eGFR (mL/min)
Diarrhoea onset
Diarrhoea duration
Other AEs
1/M/50 2/M/48 3/M/50 4/F/49 5/F/44 6/F/67 7/M/71
17 29 28 22 15 76 18
C1D11 C2D11 C1D4 C1D4 C5D11 C1D4 C3D11
4d 2m 7d 2w 2w NR 1m
N, T ARF ARF N N, T
eGFR = estimated glomerular filtration rate; C = cycle; D = day; d = days; m = months; w = weeks; N = neuropathy; T = thrombocytopenia; ARF = acute renal failure; NR = not reported
The patients received bortezomib [route not stated] 1.3 mg/m2 on days 1, 4, 8, and 11, every 21 days. Patients 1 and 6 also received dexamethasone, and did not develop any adverse events (AEs) other than diarrhoea. Those who received bortezomib alone experienced more frequent diarrhoea and had additional AEs. Diarrhoea appeared to occur in the early courses of chemotherapy and, in most patients, it was transient and resolved despite the continued use of bortezomib with no dosage adjustment. However, it led to acute deterioration of chronic renal failure in patients 3 and 4. Other possible causes of diarrhoea were excluded, and diarrhoea was considered related to bortezomib use. [Patient outcomes for other AEs not stated.] Author comment: "[B]ortezomib seems to render patients with renal impairment a series of inflammatory events that lead to diarrhea and the use of dexamethasone combined with bortezomib prevents its occurrence or at least decreases its severity." Kaygusuz I, et al. Bortezomib in patients with renal impairment. Hematology 16: 200-208, No. 4, Jul 2011. Available from: URL: http:// 803060719 dx.doi.org/10.1179/102453311x13025568941880 - Turkey
0114-9954/10/1371-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 1 Oct 2011 No. 1371
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