| Autor: |
Jew Win Kuan, Sing Ling Chai, Pathmanathan Rajadurai, Lee Gong Lau, Joseph Uchang, Sharifah Noor Akmal Syed Husain |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Case Reports in Hematology, Vol 2022 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2090-6579 |
| DOI: |
10.1155/2022/4081971 |
| Popis: |
Central nervous system (CNS) involvement in multiple myeloma (MM) (MM-CNS) in the form of leptomeningeal myelomatosis or brain parenchyma plasmacytoma is rare, causing challenges in clinical diagnosis and treatment. We would like to report a case of leptomeningeal myelomatosis and illustrated the challeges. A 61-year-old man was diagnosed with MM with left paravertebral plasmacytoma, R-ISS II with high suspicion of double-hit MM, either biallelic aberrancy of TP53 or del(17p) and IGH aberrancy depending on the definition chosen, treated with lenalidomide-bortezomib-dexamethasone and local radiotherapy, later developed systemic relapse and progression to MM-CNS in the form of leptomeningeal myelomatosis. A modified CNS-based treatment not reported before, consisting of daratumumab, pomalidomide, vincristine, procarbazine, and dexamethasone, brought a rapid clinical improvement and warrants a further study. Incorporation of intrathecal thiotepa into the regimen would likely increase the efficacy. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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