Wanchoo Rimda, Khan Seyyar, Kolitz Jonathan E, Jhaveri Kenar D
Division of Kidney Diseases and Hypertension, Hofstra NS-LIJ School of Medicine, Great Neck, NY, USA.
Don Monti Division of Oncology/Division of Hematology, Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Lake Success, New York.
J Oncol Pharm Pract. 2015 Aug;21(4):313-6. doi: 10.1177/1078155214531804. Epub 2014 Apr 18.
Carfilzomib is a second-generation epoxyketone proteasome inhibitor that is approved for treatment of relapsed and refractory multiple myeloma. Phase 2 trials have reported that 25% of treated patients have renal adverse effects. Pre-renal/vasoconstriction-related insult from this chemotherapy agent has been documented. We describe a case of a 78-year-old man with refractory multiple myeloma with acute kidney injury associated with carfilzomib treatment. We show that use of N-acetyl-l-cysteine in our patient partially mitigated the renal injury upon re-challenge. This case report hypothesizes that acute renal injury from carfilzomib is caused by vasoconstriction of the renal vessels, which may be prevented by N-acetyl-l-cysteine.
卡非佐米是一种第二代环氧酮蛋白酶体抑制剂，已被批准用于治疗复发和难治性多发性骨髓瘤。2期试验报告称，25%的接受治疗的患者有肾脏不良反应。这种化疗药物引起的肾前/血管收缩相关损伤已有文献记载。我们描述了一例78岁患有难治性多发性骨髓瘤的男性患者，其急性肾损伤与卡非佐米治疗有关。我们发现，在我们的患者中使用N-乙酰半胱氨酸在再次用药时部分减轻了肾损伤。本病例报告推测，卡非佐米引起的急性肾损伤是由肾血管收缩所致，而N-乙酰半胱氨酸可能预防这种损伤。
