Hacihanefioglu Abdullah, Tarkun Pinar, Gonullu Emel
Faculty of Medicine, Department of Hematology, Kocaeli University, Umuttepe Campus, 41380, Kocaeli, Turkey.
Int J Hematol. 2008 Sep;88(2):219-222. doi: 10.1007/s12185-008-0139-7. Epub 2008 Jul 17.
We present here a case of severe congestive cardiac failure, in a 47-year-old patient with myeloma who had no prior cardiac history, after receiving bortezomib. Bortezomib is a boron-containing molecule, which reversibly inhibits the proteasome, an intracellular organelle, which is central to the breakdown of ubiquitinated proteins and consequently crucial for normal cellular homeostasis. Phase II clinical trials demonstrate that it is effective for the treatment of relapsed refractory myeloma. Acute development of congestive cardiac failure associated with bortezomib therapy occurs very rarely or may be underestimated. Inhibition of proteasome activity may impair cardiac function due to accumulation of unfolded, damaged and undegraded proteins in myocytes. Patients with or without cardiac disease or previously received anthracycline-containing regimes should be closely monitored when being subjected to treatment with bortezomib.
我们在此呈现一例严重充血性心力衰竭病例，患者为一名47岁的骨髓瘤患者，既往无心脏病史，在接受硼替佐米治疗后出现该症状。硼替佐米是一种含硼分子，它可逆性抑制蛋白酶体，蛋白酶体是一种细胞内细胞器，对泛素化蛋白的分解至关重要，因此对正常细胞稳态至关重要。II期临床试验表明，它对复发难治性骨髓瘤的治疗有效。与硼替佐米治疗相关的充血性心力衰竭急性发作非常罕见，或者可能被低估。蛋白酶体活性的抑制可能会损害心脏功能，因为未折叠、受损和未降解的蛋白质在心肌细胞中积累。无论有无心脏病或先前接受过含蒽环类药物方案治疗的患者，在接受硼替佐米治疗时均应密切监测。
