Reversible posterior encephalopathy syndrome associated with bortezomib

Terwiel, E; Hanrahan, R; Lueck, Christian J.; D’Rozario, James

doi:10.1111/j.1445-5994.2009.02097.x

Cited by 21 publications

(11 citation statements)

References 16 publications

(16 reference statements)

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“…Bortezomib competitively inhibits the ChTL activity of all proteasome forms and induces apoptosis preferentially in neoplastic cells. At the same time, bortezomib exhibits side effects: fatigue and weakness, gastrointestinal disturbances, thrombocytopenia, acute pancreatitis, encephalopathy syndrome [35][36][37]. Besides, under the pressure of the continuous proteasome inhibition, cells switch on adaptive feedback mechanisms to eliminate the lethal attack of proteasome inhibitors [38,39].…”

Section: Changes In the Proteasome Pool In The Development Of Human Pmentioning

confidence: 99%

Changes in proteasome pool in human papillary thyroid carcinoma development

et al. 2011

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Searching the antitumor drug targets among proteasomes, “ubiquitous” enzyme systems, may provide a new impulse to the antitumor drug discovery. In this study, changes in the proteasome pool in the development of human papillary thyroid carcinoma were determined. Proteasome activities were evaluated by hydrolysis of commercial fluorogenic peptides. Changes in the expression of the total proteasome pool, proteasome 19S activator and proteolytic constitutive subunits X(β5), Y(β1) and immune subunits LMP7 (β5i) and LMP2 (β1i) were investigated by Western blotting. The distribution of the proteasome subunits in thyroid gland cells was detected by immunohistochemistry. It was shown that the chymotrypsin- and caspase-like activities as well as the expression of the total proteasome pool, proteasome 19S activator and immune subunits increased gradually in the tumors at the T2N0M0 and T3N0M0 stages in comparison with the control tissues. Among the structures studied, the expression of the 19S activator and immune proteasomes, which contain the LMP2 (β1i) subunit, was enhanced to the largest degree in tumor cells. The data obtained may be implicated in a new therapeutic strategy. Taking into consideration the antitumor function of the immune proteasomes, we advance the 19S activator as the target for the development of a novel antitumor therapy.

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Section: Changes In the Proteasome Pool In The Development Of Human Pmentioning

confidence: 99%

Changes in proteasome pool in human papillary thyroid carcinoma development

et al. 2011

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“…The PI bortezomib (Velcade, PS-341) can induce apoptosis, reverse drug resistance of MM, and also affect their micro-environment by blocking cytokine circuits, angiogenesis and cell adhesions [3]. It has been reported that bortezomib can cause reversible posterior leucoencephalopathy (RPLS), which is commonly caused by hypertensive encephalophathy, immunosuppressants, or chemotherapy [4]. The clinical manifestations of RPLS include seizures, headache, altered mental state and visual loss, which is to some extent similar to our case.…”

Section: Discussionmentioning

confidence: 99%

Mania in a Patient With Multiple Myeloma After Using Bortezomib

et al. 2014

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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.

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“…PRES is a rare and potentially harmful complication of multiple myeloma (3,5,6). We herein describe a case involving a presentation typical of PRES, in both clinical and radiological aspects, attributed to bortezomib as the most possible offending agent.…”

Section: Discussionmentioning

confidence: 99%

“…Although PRES has been increasingly identified within the setting of oncology among patients receiving chemotherapy and targeted agents (1, 2), only four cases associated with bortezomib treatment have been reported to date (3,(5)(6)(7). The clinical characteristics, including those of the present case, are outlined in Table. Among these cases, there was a female predominance (80%) and preferential attacks among subjects more than fifty years of age.…”

mentioning

confidence: 94%

Bortezomib-induced Posterior Reversible Encephalopathy Syndrome: Clinical and Imaging Features

2014

Intern. Med.

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Posterior reversible encephalopathy syndrome (PRES) is a rare and potentially harmful complication in patients receiving targeted chemotherapy. We herein present a case of PRES that occurred after 33 days of high-dose bortezomib treatment and propose both overwhelmed cerebral autoregulation and toxin-mediated blood-brain barrier damage as the underlying mechanisms based on the imaging findings. A favorable recovery was observed two days after achieving stringent hypertension control and withholding bortezomib. Follow-up images obtained two weeks later unveiled a dramatic remission, with faint areas of subcortical hyperintensity in the bilateral parieto-occipital regions. With explicit clinical and imaging features, this case highlights the need for early recognition of PRES during the clinical course of bortezomib therapy.

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Reversible posterior encephalopathy syndrome associated with bortezomib

Cited by 21 publications

References 16 publications

Changes in proteasome pool in human papillary thyroid carcinoma development

Changes in proteasome pool in human papillary thyroid carcinoma development

Mania in a Patient With Multiple Myeloma After Using Bortezomib

Bortezomib-induced Posterior Reversible Encephalopathy Syndrome: Clinical and Imaging Features

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