Oda Yuzo, Ooi Shinji, Endoh Akira, Urushidani Yoshinori, Nakamura Rika, Adachi Koji
Dept. of Hematology, Immunology and Nephrology, Matsue Red Cross Hospital, Japan.
Gan To Kagaku Ryoho. 2011 Mar;38(3):489-92.
A 64-year-old male consulted our clinic due to pancytopenia. Bone marrow appearance was consistent with multiple myeloma and an IgG-κ type M component was detected on electroimmuno-diffusion of urine. MP therapy (melphalan 2 mg/ day, prednisolone 10 mg/day) was started on an outpatient basis, but the pancytopenia worsened. The patient was then admitted to our hospital, and a course of Velcade therapy (bortezomib 2. 4 mg day 1, 4, 8, 11) was started. After a course of Velcade therapy, side effects such as gastrointestinal dysfunction appeared. A month after the disruption of the chomotherapy, the patient suddenly died. The autopsy report stated that the atrial blood showed 19, 200/μL of white blood cells and 39% of plasma cells, and a slight infiltration was found in liver, kidney and vessels. Two days before death, the blood picture showed no plasma cells. The cause of death was considered to be aggressive multiple myeloma.
一名64岁男性因全血细胞减少前来我院就诊。骨髓检查结果符合多发性骨髓瘤，尿免疫电泳检测发现IgG-κ型M蛋白成分。门诊开始采用MP方案治疗（美法仑2mg/天，泼尼松龙10mg/天），但全血细胞减少症状加重。随后患者入住我院，开始使用万珂方案治疗（硼替佐米2.4mg，第1、4、8、11天）。一个疗程的万珂治疗后，出现了胃肠功能紊乱等副作用。化疗中断一个月后，患者突然死亡。尸检报告显示心房血白细胞计数为19,200/μL，浆细胞占39%，肝脏、肾脏和血管有轻度浸润。死亡前两天，血常规检查未发现浆细胞。死因考虑为侵袭性多发性骨髓瘤。
