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Lack of efficacy: case report A 61-year-old woman experienced lack of efficacy following treatment with lenalidomide for multiple myeloma. She also experienced lack of efficacy following treatment with plerixafor for stem cell mobilisation [routes not stated; not all dosages stated]. The woman, who presented with weakness, dyspnoea, weight loss and palpitations in April 2012, was diagnosed with stage III multiple myeloma (IgG kappa type). She received 4 courses of bortezomib, cyclophosphamide and dexamethasone. According to the International Myeloma Working Group (IMWG), a partial remission in MM was observed following completion of the 4 courses of bortezomib, cyclophosphamide and dexamethasone. Four weeks after the completion of bortezomib, cyclophosphamide and dexamethasone, she underwent an autologous transplant. She started receiving lenalidomide 10mg as maintenance therapy after the transplant. After 17 cycles of lenalidomide treatment, she was diagnosed with extramedullary plasmacytomas. Consequently, she received DT-PACE regimen comprising thalidomide, vincristine, doxorubicin, cisplatin, dexamethasone and etoposide. After 2 cycles of the DT-PACE regimen, she had a minimal response, according to the IMWG criteria. The second autologous bone marrow transplantation could not be performed, since sufficient stem cells could not be stored during the first stem cell collection and that stem cell mobilisation was not achieved despite plerixafor administration. The woman then received KD regimen comprising carfilzomib and dexamethasone. After 6 cycles of the KD regimen, a complete remission was noted in the extramedullary plasmacytomas. She received total 40 courses of carfilzomib and her extramedullary plasmacytomas remained in remission. Atalay F. The use of carfilzomib to treat extramedullary plasmacytoma and review of the literature. Journal of Applied Hematology 11: 74-76, No. 2, Jun 2020. Available from: URL: http://doi.org/10.4103/joah.joah_83_19 803518430

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Reactions 5 Dec 2020 No. 1833