Mania in a Patient With Multiple Myeloma After Using Bortezomib

Abstract

Multiple myeloma (MM) is caused by a clonal proliferation of malignant plasma cells and ranks the second most frequent malignancy of hematology. Despite emerging intensive therapies including new agents and high-dose treatment with stem-cell transplantation, MM still remains an incurable neoplastic disease. Bortezomib was the first proteasome inhibitor (PI) which can improve response rates and overall survival in both newly diagnosed and recurrent MM patients with few adverse effects. The patient was a 61-year-old woman with MM who suffered from mania after initially receiving chemotherapy regimen of PTD (bortezomib, thalidomide, dexamethasone). The regimen was forced to stop due to the severe adverse effect. Then the symptoms were relieved and the patient was given VAD (vincristine, adriamycin, dexamethasone) regimen, and mania was never performed again. It has not been shown that bortezomib can lead to mania in MM patients in the introduction of the drug. Timely detection, immediately stopping related drugs and treating the primary disease actively are key steps for improvement. Poor psychosocial state is another crucial factor which ought to be taken into account in the prevention and treatment of mania occurrence.