Crohn's disease is a chronic transmural inflammatory disorder characterized by inflammation of the intestine. Anti-TNF-α drugs are used for induction and maintenance of remission in patients with this condition. Thrombocytopenia is an uncommon side effect of treatment with anti-TNF-α drugs. We report the case of a 71-year-old woman diagnosed with Crohn's disease who developed severe adalimumab-induced thrombocytopenia and who did not respond to standard therapy for thrombocytopenia.

Between 20-40% of patients with multiple myeloma (MM) present with renal impairment (RI) at diagnosis (Korbet & Schwartz, 2006; Kastritis et al., 2007) and up to 10% of them require dialysis (Dimopoulos et al., 2010). Prognosis in these patients remains significantly worse when compared with patients with normal renal function (Haynes et al., 2010). Daratumumab is an anti-CD38 IgG kappa human monoclonal antibody that has demonstrated superior clinical benefit across lines of therapy, either as monotherapy or when combined with standard-of-care regimens for the treatment of patients with relapsed and refractory MM (RRMM) (Usmani et al., 2016; van de Donk et al., 2016). However, data of daratumumab in patients with RRMM and dialysis-dependant renal failure are lacking. We report the efficacy and safety results from a retrospective Spanish study of daratumumab in patients with RRMM and end-stage RI requiring dialysis. Methods M.J.C. performed the research and contributed to analyzing of data and paper writing. J.D.L.R. was involved in designing the study, analysis, interpretation and reporting of the data, and wrote/reviewed the paper. All authors performed the research and reviewed the draft manuscript and approved the final version for publication.

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Lenalidomide is an oral immunomodulatory drug that has helped improve outcomes in multiple myeloma (MM) patients. Combination lenalidomide and dexamethasone (Len+Dex) has been shown to increase response rates and prolong survival compared with dexamethasone alone in patients with relapsed or refractory MM (RRMM). Clinical benefit may be greatest when Len+Dex is given at first relapse, and continued treatment appears to provide greater depth of response and improved survival outcomes. The most common adverse events associated with Len+Dex are cytopenias, which are predictable and manageable. Len+Dex is associated with an increased risk of venous thromboembolism, which necessitates adequate prophylaxis. The risk of second primary malignancies does not appear to be increased in patients with RRMM treated with lenalidomide-based therapy. Here we review the safety and efficacy of Len+Dex in RRMM, and provide an overview of data from Spain on the use of Len+Dex in RRMM.