一名老年瓦尔登斯特伦巨球蛋白血症患者在接受含硼替佐米和地塞米松方案治疗后发生坏死性筋膜炎。
Necrotising fasciitis after bortezomib and dexamethasone-containing regimen in an elderly patient of Waldenström macroglobulinaemia.
作者信息
Morita Tomohiro, Ugai Tomotaka, Tanimoto Tetsuya, Matsue Kosei
机构信息
Kameda Medical Center, Kamogawa, Chiba, Japan.
出版信息
BMJ Case Rep. 2014 Mar 26;2014:bcr2013203399. doi: 10.1136/bcr-2013-203399.
Abstract
Bortezomib and high-dose dexamethasone-containing regimens are considered to be generally tolerable with few severe bacterial infections in patients with B-cell malignancies. However, information is limited concerning the safety of the regimen in elderly patients. We report a case of a 76-year-old man with Waldenström macroglobulinaemia who suffered necrotising fasciitis without neutropenia after the combination treatment with bortezomib, high-dose dexamethasone and rituximab. Despite immediate intravenous antimicrobial therapy, he succumbed 23 h after the onset. Physicians should recognise the possibility of fatal bacterial infections related to bortezomib plus high-dose dexamethasone in elderly patients, and we believe this case warrants further investigation.
摘要
硼替佐米和含大剂量地塞米松的治疗方案通常被认为耐受性良好，B细胞恶性肿瘤患者中严重细菌感染较少。然而，关于该方案在老年患者中的安全性信息有限。我们报告一例76岁患有华氏巨球蛋白血症的男性患者，在接受硼替佐米、大剂量地塞米松和利妥昔单抗联合治疗后，未出现中性粒细胞减少却发生了坏死性筋膜炎。尽管立即进行了静脉抗菌治疗，他在发病后23小时死亡。医生应认识到老年患者中与硼替佐米加大剂量地塞米松相关的致命细菌感染的可能性，我们认为该病例值得进一步研究。
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