Yang Guangzhong, Geng Chuanying, Li Yanchen, Liu Aijun, Chen Wenming
Department of Hematology and Multiple Myeloma Research Center of Beijing, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
Exp Ther Med. 2013 Oct;6(4):883-886. doi: 10.3892/etm.2013.1246. Epub 2013 Aug 5.
In this study, the case of a 60-year-old female patient who presented with a subcutaneous mass in the lower right limb is described. The mass was confirmed as a plasmacytoma. The patient was diagnosed with multiple myeloma (MM) λ type stage III international stage system (ISS) and received three cycles of a therapeutic PDT regimen (bortezomib, dexamethasone and thalidomide) and complete remission was achieved. Following a further two cycles of the PDT regimen, the patient proceeded to received a high-dose cyclophosphamide regimen combined with granulocyte-colony stimulating factor (G-CSF) for stem cell mobilization. Fourteen months later, the patient received a high-dose therapy supported by autologous stem cell transplantation (auto-SCT). After six months, a subcutaneous mass was identified in the left side of the patient's neck and the mass gradually increased in size. The patient exhibited exophthalmos and loss of sight one month later. The masses in the neck and right eyelid of the patient were diagnosed as plasmacytomas. These results, combined with the results of bone marrow (BM) aspiration and protein electrophoresis with immunofixation electrophoresis revealed that the disease had relapsed. The patient received two cycles of a therapeutic CPADT regimen (cyclophosphamide, bortezomib, pharmorubicin, dexamethasone and thalidomide). The patient subsequently achieved complete remission again. The patient refused to continue receiving bortezomib and pharmorubicin for therapy and instead received four cycles of the therapeutic CTD regimen (cyclophosphamide, dexamethasone and thalidomide). Subsequently the patient received local radiotherapy for the masses in the eyes and neck. The patient remained stable after treatment following the initial relapse with a progression-free survival (PFS) time of eight months.
本研究描述了一名60岁女性患者的病例，该患者右下肢出现皮下肿块。该肿块经确诊为浆细胞瘤。患者被诊断为多发性骨髓瘤（MM）λ型国际分期系统（ISS）III期，并接受了三个周期的治疗性PDT方案（硼替佐米、地塞米松和沙利度胺），实现了完全缓解。在进一步接受两个周期的PDT方案后，患者接着接受了高剂量环磷酰胺方案联合粒细胞集落刺激因子（G-CSF）以进行干细胞动员。14个月后，患者接受了自体干细胞移植（auto-SCT）支持的高剂量治疗。6个月后，在患者颈部左侧发现一个皮下肿块，且肿块大小逐渐增大。1个月后，患者出现眼球突出和失明。患者颈部和右眼睑的肿块被诊断为浆细胞瘤。这些结果，结合骨髓穿刺结果以及免疫固定电泳的蛋白电泳结果显示疾病复发。患者接受了两个周期的治疗性CPADT方案（环磷酰胺、硼替佐米、表柔比星、地塞米松和沙利度胺）。患者随后再次实现完全缓解。患者拒绝继续接受硼替佐米和表柔比星治疗，转而接受了四个周期的治疗性CTD方案（环磷酰胺、地塞米松和沙利度胺）。随后，患者接受了眼部和颈部肿块的局部放疗。在初次复发后的治疗后，患者病情保持稳定，无进展生存期（PFS）为8个月。
