Daratumumab for Refractory IgD Multiple Myeloma with Lung Cancer and Persistent Thrombocytopenia: a Case Report

Wang, Zhihui; Deng, Hong; Zhang, Liang; Dai, Yaxing; Li, Xianglong; Lin, Xiaojing; Wei, Jin; Zou, Xing-Li

doi:10.7754/clin.lab.2021.210405

Cited by 3 publications

(3 citation statements)

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“…In addition, there are currently other treatment options for younger patients, including bortezomib, lenalidomide, dexamethasone (+/-), daratumumab with/without consolidating high-dose chemotherapy, and autologous stem cell transplantation [20]. Moreover, daratumumab has been reported to be safe and effective for MM with LC, displayed benefits in survival and can induce complete remission to proceed to LC surgery [21,22]. In our case, the patient underwent partial surgical resection of the tumor followed by spinal stabilization, which achieved pain relief and the protection of her sensory function.…”

Section: Discussionmentioning

confidence: 99%

Multiple Myeloma Rather Than Metastatic Lung Cancer: An Unexpected Cause of Spinal Cord Compression

Chen,

Yan,

Liu

et al. 2023

World J Oncol

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Spinal cord compression caused by cancer metastasis is a medical emergency that should be managed positively. Both multiple myeloma and lung cancer can lead to metastatic deposits in the spinal column to induce compression of the spinal cord. However, co-occurring multiple myeloma and lung cancer in a single patient causing spinal cord compression are rarely reported in the literature. We describe a case of a 61-year-old female with multiple myeloma and lung cancer whose radiologic characteristics of spinal cord compression mimicked those of metastatic lung cancer. Finally, the diagnosis was multiple myeloma. We showed the systematic imaging manifestations of metastatic multiple myeloma and discussed their therapeutic management.

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Section: Discussionmentioning

confidence: 99%

Multiple Myeloma Rather Than Metastatic Lung Cancer: An Unexpected Cause of Spinal Cord Compression

Chen,

Yan,

Liu

et al. 2023

World J Oncol

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“…When suffering from lung cancer and MM, the chronological occurrence of the two cancers needs to be clarified. Fewer than 20 cases of MM with lung cancer have been reported so far; four of these cases were lung adenocarcinoma cases and MM and lung cancer occurred simultaneously in only two cases (11,(13)(14)(15)(16)(17)(18)(19)(20). Zuo et al (17) reported a rare case of simultaneous MM and pulmonary adenocarcinoma; the patient was treated with bortezomib and is stable.…”

Section: Discussionmentioning

confidence: 99%

“…IgD multiple myeloma (IgD MM) is rare, accounting for ~1-2% of myeloma cases (29). Wang et al (19) reported a case of IgD MM complicated with lung cancer that was treated with surgery and anti-CD38 monoclonal antibody (daratumumab); the patient achieved complete remission. The case in the present study was also IgD MM and lung cancer was treated surgically, but the VDT scheme was adopted, autologous stem cell transplantation and long-term thalidomide treatment after operation.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous multiple myeloma and non‑small cell lung carcinoma: A case report and review of the literature

Dong

Kang

et al. 2022

Oncol Lett

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Multiple myeloma (MM) is the second commonest hematologic malignancy. Synchronous presentation of MM and lung cancer is a rare occurrence. The present study reports a case of MM combined with lung cancer and reviews previously reported cases of the co-existence of non-small cell lung carcinoma and MM. At Hebei General Hospital (Shijiazhuang, China), a 52-year-man was diagnosed with MM complicated by lung lesion. Lung computed tomography (CT) showed an increase in lesion density after the second cycle of chemotherapy. The lesion was surgically removed and the patient was diagnosed with non-small cell lung carcinoma by lung biopsy pathology. After the fifth cycle of VDT (bortezomib, dexamethasone and thalidomide), the patient received autologous stem cell transplantation. Immunohistochemical staining for CD38, CD138, CD39, CD203a and TNF-α were positive in both MM and lung cancer; CD73 was only positive in lung cancer. The present study described the rare event of the simultaneous occurrence of MM and lung adenocarcinoma and discussed the potential link between the two tumors. CD38 may play a role in MM and lung cancer by changing the bone marrow microenvironment through adenosine.

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Antineoplastics

2022

Reactions Weekly

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Lack of efficacy and infusion reaction: case reportA 62-year-old man exhibited lack of efficacy during treatment with ixazomib, cyclophosphamide and dexamethasone for IgD-λ multiple myeloma (MM). Subsequently, he developed grade II infusion reaction during treatment with daratumumab for IgD-λ MM.In November 2018, the man first presented to the clinic with the chief complaint of palpitation and fatigue. After a thorough investigation a diagnosis of IgD-λ MM (International staging system stage 2) was made. Studies revealed serum M-protein of 2.85g/L, 24-hour urinary light chain of 0.12g, and chromosome 1q21 amplification and normal level of serum creatinine and lactate dehydrogenase. Further studies revealed moderate osteoporosis and no extramedullary lesions. Since, he had no remarkable comorbidities, he was considered transplant-eligible. Thereafter, he received induction chemotherapy with VTD regimen consisting of bortezomib, thalidomide, and dexamethasone. After four cycles of chemotherapy, he showed recovery in peripheral blood count and achieved very good partial response. To mobilize stem cells, etoposide in combination with filgrastim [recombinant human granulocyte colony stimulating factor] was adopted. A total of 8.25 × 10 6 /kg CD34+ cells were collected. After another two cycles of VTD chemotherapy, he received high-dose melphalan with autologous stem cell support and post transplant he achieved stringent complete remission (sCR). It was revealed that, he had a negative minimal residual disease. Thereafter, he started receiving maintenance therapy with lenalidomide. Until the outbreak of COVID-19, he was regularly followed up after which it was interrupted. Since, persistent sCR had been maintained during his follow-up prior to the COVID-19; according to the previous schedule at home, he continued to take lenalidomide. About after 3 months, he developed serious weakness due to which he visited clinic. Studies suggested a recurrence of IgD-λ MM. Additionally 3.6% myeloma cells were also detected in his peripheral blood. Further studies revealed a solid pulmonary nodule in the right lower lobe, which had been inconspicuous on his last studies. Thereafter, he received platelet transfusion. Afterwards, studies confirmed the diagnosis of moderately differentiated squamous lung cancer. However, on account of the worsening performance status and cytopenia, as well as due to concerns about the dissemination of circulating plasma cells, the lung cancer surgery was put on hold. Thereafter, chemotherapy for MM was planned aiming to improve his thrombocytopenia and fragility so that the risk of surgery could be reduced. Thereafter, due to its convenience during the COVID-19 pandemic, he started receiving chemotherapy regimen ICD consisting of oral ixazomib 4 mg at days 1, 8, 15; oral cyclophosphamide 400mg and oral dexamethasone 40mg at days 1, 8, 15, 22. However, he exhibited severe bone marrow suppression leading to persistent pancytopenia after chemotherapy. Therefore, lack of efficacy was considered for ixazomi...

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Daratumumab for Refractory IgD Multiple Myeloma with Lung Cancer and Persistent Thrombocytopenia: a Case Report

Cited by 3 publications

References 0 publications

Multiple Myeloma Rather Than Metastatic Lung Cancer: An Unexpected Cause of Spinal Cord Compression

Multiple Myeloma Rather Than Metastatic Lung Cancer: An Unexpected Cause of Spinal Cord Compression

Simultaneous multiple myeloma and non‑small cell lung carcinoma: A case report and review of the literature

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