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Venetoclax in combination with carfilzomib and dexamethasone in relapsed/refractory multiple myeloma harboring t(11,14)(q13;q32): two case reports and a review of the literature
- Source :
- Journal of Medical Case Reports, Vol 14, Iss 1, Pp 1-6 (2020), Journal of Medical Case Reports
- Publication Year :
- 2020
- Publisher :
- BMC, 2020.
-
Abstract
- Background Multiple myeloma has witnessed significant advances due to the approval of many novel agents. However, in spite of all these new developments, multiple myeloma remains an incurable disease with inevitable relapse in the majority of patients. Venetoclax is a selective antiapoptotic protein B-cell lymphoma 2 inhibitor that induces cell death in multiple myeloma cells, particularly in those harboring t(11,14)(q13;q32). We report two cases of patients with multiple myeloma with t(11,14)(q13;q32) who were treated with venetoclax/carfilzomib/dexamethasone with rapid initial response; however, the response was short-lived. Cases presentation Patient 1 was a 50-year-old Saudi man with International Staging System stage III kappa light chain multiple myeloma with normal karyotype diagnosed in May 2013. He received bortezomib/thalidomide/dexamethasone treatment and underwent autologous hematopoietic stem cell transplant. Three years later, he presented with disease progression and received multiple lines of chemotherapy, including carfilzomib/lenalidomide/dexamethasone. Venetoclax/carfilzomib/dexamethasone was started after acquiring t(11,14)(q13;q32) 5 years into his disease course. He achieved complete remission, with disease progression after cycle 6. Patient 2 was a 48-year-old Saudi man with International Staging System stage III immunoglobulin G kappa multiple myeloma with t(11,14)(q13;q32) diagnosed in May 2017. He received bortezomib/thalidomide/dexamethasone treatment and underwent autologous hematopoietic stem cell transplant. Eighteen months later, he had disease progression, and he received multiple lines of chemotherapy, including carfilzomib/dexamethasone. He was shifted to venetoclax/carfilzomib/dexamethasone in April 2019 and had an initial clinical response; two months later, he progressed to plasma cell leukemia with rapid deterioration to multiorgan failure. Conclusions Acquired t(11;14)(q13;q32) is unreported in the multiple myeloma literature. In the era of targeted therapy, it is essential to repeat the cytogenetic and multiple myeloma fluorescence in situ hybridization panel with each disease progression. Multiple myeloma remains a challenging hematological malignancy despite advances in personalized/precision medicine.
- Subjects :
- Oncology
Male
medicine.medical_specialty
lcsh:Medicine
Case Report
Antineoplastic Agents
Dexamethasone
t(11:14)(q13
q32)
Venetoclax
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Fatal Outcome
immune system diseases
Multiple myeloma
Internal medicine
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Lenalidomide
Plasma cell leukemia
Sulfonamides
Bortezomib
business.industry
Remission Induction
lcsh:R
Hematopoietic Stem Cell Transplantation
General Medicine
Middle Aged
medicine.disease
Bridged Bicyclo Compounds, Heterocyclic
Carfilzomib
Thalidomide
chemistry
030220 oncology & carcinogenesis
Relapsed/refractory
Neoplasm Recurrence, Local
business
Oligopeptides
030215 immunology
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 17521947
- Volume :
- 14
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of Medical Case Reports
- Accession number :
- edsair.doi.dedup.....93016a916cb1dca04877d2927d63b930